Nursing Elites

1. A patient with a new diagnosis of diabetes insipidus is planning care. What should be included in the plan of care?

• A. Avoid alcohol
• B. Increase exercise to reduce stress
• C. Increase fluid intake
• D. Restrict sodium intake

Correct answer: A

Rationale: The correct answer is to avoid alcohol. In diabetes insipidus, excessive urination leads to fluid loss, so it is essential to avoid alcohol which can exacerbate dehydration. Choice B is incorrect as increasing exercise may not directly impact diabetes insipidus. Choice C is also incorrect because although increasing fluid intake may seem intuitive, it is not the primary concern in managing diabetes insipidus. Choice D is not directly related to managing diabetes insipidus; sodium restriction is more relevant in conditions like hypertension or heart failure.

2. After a healthcare provider misreads a glucose level and administers insulin, what is the priority intervention?

• A. Monitor for hypoglycemia
• B. Administer glucose IV
• C. Document the incident
• D. Monitor for hyperglycemia

Correct answer: A

Rationale: The correct answer is to monitor for hypoglycemia. Administering insulin based on a misread glucose level can lead to hypoglycemia. Monitoring for hypoglycemia is crucial as it is a potential adverse effect of the insulin administration. Administering glucose IV (Choice B) is not the priority as there is no indication of hypoglycemia yet. Documenting the incident (Choice C) is important but not the immediate priority over patient safety. Monitoring for hyperglycemia (Choice D) is not the priority after administering insulin in response to a misread glucose level.

3. What are the expected manifestations in a patient experiencing a thrombotic stroke?

• A. Sudden numbness or loss of function on one side of the body
• B. Sudden loss of consciousness and seizure
• C. Gradual onset of difficulty speaking
• D. Loss of sensation in the affected limb

Correct answer: A

Rationale: The correct manifestation in a patient experiencing a thrombotic stroke is sudden numbness or loss of function on one side of the body. This is due to the blockage of a blood vessel by a clot, leading to a lack of blood flow to a specific part of the brain. Choices B, C, and D are incorrect. Sudden loss of consciousness and seizure are more commonly associated with hemorrhagic strokes. Gradual onset of difficulty speaking is often seen in ischemic strokes affecting language areas, not specifically in thrombotic strokes. Loss of sensation in the affected limb is more indicative of sensory nerve damage rather than the motor deficits seen in thrombotic strokes.

4. What dietary recommendations should be provided for a patient with pre-dialysis end-stage kidney disease?

• A. Reduce phosphorus intake to 700 mg/day
• B. Increase sodium intake
• C. Restrict protein intake to 0.55-0.60 g/kg/day
• D. Limit potassium-rich foods

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. Excessive phosphorus can be harmful to individuals with kidney disease as the kidneys may not be able to effectively remove it from the body. Choices B, C, and D are incorrect. Increasing sodium intake is generally not recommended for patients with kidney disease as it can lead to fluid retention and high blood pressure. Restricting protein intake is important in later stages of kidney disease, but for pre-dialysis end-stage kidney disease, protein intake should be individualized based on the patient's condition. Limiting potassium-rich foods is more relevant for patients with advanced kidney disease or those on dialysis, as impaired kidney function can lead to high potassium levels in the blood.

5. What are the expected symptoms in a patient with a thrombotic stroke?

• A. Gradual loss of function on one side of the body
• B. Sudden loss of consciousness
• C. Severe headache and confusion
• D. Loss of sensation in the affected limb

Correct answer: A

Rationale: A thrombotic stroke typically presents with a gradual loss of function on one side of the body. This gradual onset distinguishes it from a hemorrhagic stroke, which often manifests with sudden and severe symptoms like loss of consciousness (choice B), severe headache and confusion (choice C), or loss of sensation in the affected limb (choice D). Therefore, choices B, C, and D are not typically associated with thrombotic strokes.

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