Nursing Elites

1. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which 'related-to' phrase should the nurse add?

• A. Related to bone demineralization resulting in pathologic fractures
• B. Related to exhaustion secondary to an accelerated metabolic rate
• C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
• D. Related to tetany secondary to a decreased serum calcium level

Correct answer: A

Rationale: The correct answer is A: 'Related to bone demineralization resulting in pathologic fractures.' In chronic hyperparathyroidism, bone demineralization occurs due to the excessive release of parathyroid hormone, leading to increased calcium resorption from bones. This process weakens the bones, making the client prone to pathologic fractures. Choices B, C, and D are incorrect because they do not directly relate to the increased risk of injury associated with chronic hyperparathyroidism. Exhaustion, edema, dry skin, and tetany are not the primary risks for injury in this client population.

3. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

• A. Diabetic ketoacidosis
• B. Thyroid crisis
• C. Hypoglycemia
• D. Tetany

Correct answer: B

Rationale: The correct answer is B: Thyroid crisis. Thyroid crisis, also known as thyroid storm, is a life-threatening condition that can occur after a thyroidectomy. Symptoms include high fever, tachycardia, extreme restlessness, and other signs of severe hyperthyroidism. Diabetic ketoacidosis (choice A) is a complication of diabetes characterized by hyperglycemia, ketosis, and acidosis, not typically seen post-thyroidectomy. Hypoglycemia (choice C) is low blood sugar levels and would not present with the symptoms described. Tetany (choice D) is a condition of involuntary muscle spasms due to low calcium levels and is not directly related to the symptoms observed in this scenario.

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. How often should rotation sites for insulin injection be separated from one another?

• A. Every third day.
• B. Every week.
• C. Every 2-3 weeks.
• D. Every 2-4 weeks.

Correct answer: C

Rationale: Insulin injection sites should be rotated every 2-3 weeks to prevent lipodystrophy and ensure proper insulin absorption. Option A ('Every third day') is too frequent and does not allow enough time for the previous site to heal properly. Option B ('Every week') might not provide adequate time for the tissue to recover. Option D ('Every 2-4 weeks') could potentially lead to overuse of a single injection site, increasing the risk of lipodystrophy and inconsistent insulin absorption. Therefore, the recommended interval of every 2-3 weeks is optimal for insulin injection site rotation.

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