Nursing Elites

1. A client with hypothyroidism is receiving levothyroxine therapy. The healthcare provider should monitor for which of the following signs of medication overdose?

• A. Bradycardia
• B. Weight gain
• C. Tachycardia
• D. Cold intolerance

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Tachycardia is a sign of levothyroxine overdose, indicating that the dose may need to be adjusted. Bradycardia (Choice A) is a sign of hypothyroidism, not an overdose of levothyroxine. Weight gain (Choice B) and cold intolerance (Choice D) are also symptoms of hypothyroidism, not medication overdose.

2. A client with DM asks a nurse why it is necessary to rotate injection sites when using an insulin pen. The nurse's best response would be:

• A. To prevent scar tissue from forming under the skin.
• B. To make the injections less painful.
• C. To help the insulin absorb better.
• D. To keep the skin looking healthy.

Correct answer: C

Rationale: The correct answer is C: "To help the insulin absorb better." Rotating injection sites is important as it helps to ensure better insulin absorption and reduces the risk of developing lipodystrophy. Option A is incorrect as rotating sites primarily aims to optimize insulin absorption, not prevent scar tissue. Option B is inaccurate because rotating injection sites does not necessarily make the injections less painful. Option D is incorrect as the primary reason for rotating injection sites is not related to the aesthetics of the skin but rather to enhance insulin absorption and prevent complications.

3. Working in a stressful work environment, nursing requires effective nurse managers. Which of the following skills is necessary for a nurse manager to be effective?

• A. Clinical knowledge
• B. Managerial skills
• C. Patient care coordination
• D. Human resource training

Correct answer: B

Rationale: Managerial skills are crucial for nurse managers to be effective. They need to possess skills such as problem-solving and decision-making to handle various challenges in the healthcare setting. Clinical knowledge (choice A) is important for direct patient care but may not be the primary focus of a manager's role. Patient care coordination (choice C) is vital, but managerial skills are more directly related to a nurse manager's effectiveness. Human resource training (choice D) is helpful but not as essential as managerial skills in ensuring effective leadership in a nursing environment.

4. Albert refuses his bedtime snack. This should alert the healthcare provider to assess for:

• A. Elevated serum bicarbonate and decreased blood pH.
• B. Signs of hypoglycemia earlier than expected.
• C. Symptoms of hyperglycemia due to NPH insulin peak time.
• D. Presence of sugar in the urine.

Correct answer: B

Rationale: When a patient like Albert refuses his bedtime snack, it can lead to hypoglycemia, especially if they are on medication such as insulin. Hypoglycemia can occur earlier than expected due to the lack of carbohydrate intake before bedtime. This situation warrants the healthcare provider to monitor for signs and symptoms of hypoglycemia. Choice A is incorrect because the given scenario is more indicative of hypoglycemia than metabolic alkalosis. Choice C is incorrect as NPH insulin peak time is not directly related to skipping a bedtime snack. Choice D is incorrect as sugar in the urine typically indicates hyperglycemia, not hypoglycemia.

5. A client with type 2 DM is being taught about the importance of foot care. Which instruction should the nurse include?

• A. Wear comfortable shoes that allow air circulation.
• B. Walk barefoot whenever possible.
• C. Use a heating pad to warm your feet.
• D. Soak your feet in hot water every night.

Correct answer: A

Rationale: The correct instruction for a client with type 2 diabetes mellitus (DM) regarding foot care is to wear comfortable shoes that allow air circulation. This recommendation helps prevent foot injuries and infections, which are common concerns for individuals with diabetes. Choice B, walking barefoot, can increase the risk of injuries and wounds due to reduced sensation in the feet often seen in diabetes. Choice C, using a heating pad, can lead to burns or skin damage if the temperature is not carefully monitored, making it an unsafe practice. Choice D, soaking feet in hot water every night, can also be harmful as it can cause burns and dry out the skin, leading to further complications for individuals with diabetes. Therefore, the most appropriate and safe advice is to wear comfortable shoes that promote air circulation to maintain foot health and prevent complications.

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