Nursing Elites

1. A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?

• A. Dry skin
• B. Decreased urinary output
• C. Hyperactive bowel sounds
• D. Increased specific gravity of the urine

Correct answer: C

Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.

2. Which of the following best defines management?

• A. A manager is someone who ensures that employees complete their work.
• B. A manager controls the work of employees.
• C. A manager organizes and controls a group of employees to get work done.
• D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.

Correct answer: D

Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.

3. The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?

• A. Increase intake of dairy products and green leafy vegetables
• B. Avoid foods high in calcium
• C. Consume a high-sodium diet
• D. Limit fluid intake to prevent fluid overload

Correct answer: A

Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.

4. A client with hyperthyroidism is prescribed propranolol. The nurse explains that this medication is used to:

• A. Increase thyroid hormone production
• B. Decrease thyroid hormone production
• C. Relieve symptoms such as tachycardia and anxiety
• D. Prevent weight loss

Correct answer: C

Rationale: Propranolol is a beta-blocker that works by blocking the effects of adrenaline, which helps to reduce symptoms such as tachycardia (fast heart rate) and anxiety in individuals with hyperthyroidism. Choices A and B are incorrect because propranolol does not affect thyroid hormone production; it only addresses symptoms. Choice D is incorrect because propranolol does not prevent weight loss associated with hyperthyroidism.

5. A client with type 2 diabetes mellitus is prescribed metformin. The nurse should monitor the client for which of the following potential side effects?

• A. Lactic acidosis
• B. Hypokalemia
• C. Hyperglycemia
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A, lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or predisposing factors. Monitoring for signs of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or uneven heart rate, is crucial to prevent serious complications. Choices B, C, and D are incorrect as metformin does not typically cause hypokalemia, hyperglycemia, or weight gain as its primary side effects.

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