Nursing Elites

1. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?

• A. The client with colitis
• B. The client with Cushing's syndrome
• C. The client who has been overusing laxatives
• D. The client who has sustained a traumatic burn

Correct answer: D

Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.

2. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Avoid taking the medication if you miss a meal.
• D. Take the medication before bedtime.

Correct answer: A

Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.

3. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should be reported to the healthcare provider immediately?

• A. Hyperglycemia
• B. Hypertension
• C. Low-grade fever
• D. Weight gain

Correct answer: C

Rationale: In a client with Cushing's syndrome, a low-grade fever should be reported immediately as it may indicate an infection. Clients with Cushing's syndrome are immunosuppressed, making them more susceptible to infections. Hyperglycemia and hypertension are common findings in Cushing's syndrome and are managed as part of the condition. Weight gain is also a common symptom in Cushing's syndrome and may not require immediate reporting unless it is sudden and severe.

4. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?

• A. Serum calcium.
• B. Serum phosphorus.
• C. Serum potassium.
• D. Serum sodium.

Correct answer: C

Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.

5. Which of the following ethical principles involves the fair and equitable distribution of resources?

• A. Justice
• B. Fidelity
• C. Autonomy
• D. Veracity

Correct answer: A

Rationale: The correct answer is A: Justice. Justice is the ethical principle that focuses on the fair and equitable distribution of resources, ensuring that all individuals receive appropriate care based on their needs. Fidelity (B) refers to being faithful or loyal to commitments and obligations. Autonomy (C) relates to respecting an individual's right to make their own decisions. Veracity (D) pertains to truthfulness and honesty in communication with patients.

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