Nursing Elites

1. A client newly diagnosed with DM asks a nurse why it is necessary to monitor blood glucose levels so often. The nurse's best response would be:

• A. It helps to adjust insulin doses more precisely.
• B. It helps to prevent complications of diabetes.
• C. It helps to identify the best diet for you.
• D. It helps to reduce the need for medications.

Correct answer: B

Rationale: Monitoring blood glucose levels frequently is crucial for preventing complications in diabetes. By keeping a close eye on blood glucose levels, healthcare providers can intervene in a timely manner if levels are out of range, thus reducing the risk of long-term complications such as nerve damage, kidney disease, and vision problems. Choices A, C, and D are incorrect because while monitoring blood glucose levels may indirectly contribute to adjusting insulin doses, identifying the best diet, and reducing the need for medications, the primary purpose is to prevent complications through timely interventions.

2. What health concerns should Nurse Oliver expect a client with hypothyroidism to report?

• A. Increased appetite and weight loss
• B. Puffiness of the face and hands
• C. Nervousness and tremors
• D. Thyroid gland swelling

Correct answer: B

Rationale: Puffiness of the face and hands is a classic symptom of hypothyroidism. This occurs due to fluid retention and is commonly observed in individuals with an underactive thyroid gland. Increased appetite and weight loss (Choice A) are more indicative of hyperthyroidism, where there is an overproduction of thyroid hormones leading to increased metabolism. Nervousness and tremors (Choice C) are associated with hyperthyroidism, not hypothyroidism. Thyroid gland swelling (Choice D) typically indicates goiter, which can be present in both hyperthyroidism and hypothyroidism but is not a specific symptom that clients with hypothyroidism commonly report.

3. The healthcare provider is assessing a client with Addison's disease. Which of the following symptoms is consistent with this condition?

• A. Hypertension
• B. Hyperglycemia
• C. Hyperpigmentation
• D. Weight gain

Correct answer: C

Rationale: Hyperpigmentation is a characteristic symptom of Addison's disease. In Addison's disease, there is a decrease in cortisol production, leading to an increase in adrenocorticotropic hormone (ACTH) secretion by the pituitary gland. Excess ACTH can stimulate melanocytes, resulting in hyperpigmentation. Choices A, B, and D are not typically associated with Addison's disease. Hypertension is more commonly associated with conditions involving excess cortisol production, such as Cushing's syndrome. Hyperglycemia may occur in diabetes mellitus but is not a hallmark of Addison's disease. Weight loss, rather than weight gain, is a common symptom of Addison's disease due to decreased cortisol levels.

4. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia indicated by which of the following signs?

• A. Muscle weakness
• B. Tremors
• C. Diaphoresis
• D. Constipation

Correct answer: A

Rationale: Muscle weakness is a classic manifestation of hyperkalemia, an elevated level of potassium in the blood. After an adrenalectomy, where one adrenal gland is removed, there may be a risk of hyperkalemia due to altered hormone regulation. Tremors (Choice B) are not typically associated with hyperkalemia but may be seen in conditions like hypocalcemia. Diaphoresis (Choice C) and constipation (Choice D) are not specific indicators of hyperkalemia. Diaphoresis is excessive sweating and constipation is a common gastrointestinal issue, neither directly related to potassium imbalances.

5. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?

• A. Vasopressin (Pitressin Synthetic)
• B. Furosemide (Lasix)
• C. Regular insulin
• D. 10% dextrose

Correct answer: A

Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.

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