Nursing Elites

1. In a patient with diabetes, which of the following is a sign of hypoglycemia?

• A. Polydipsia
• B. Polyuria
• C. Dry skin
• D. Sweating

Correct answer: D

Rationale: Sweating is a common sign of hypoglycemia in patients with diabetes. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, leading to symptoms such as sweating, shakiness, and palpitations. Polydipsia (excessive thirst) and polyuria (excessive urination) are more commonly associated with hyperglycemia (high blood sugar levels) in diabetes. Dry skin is not a typical symptom of hypoglycemia.

2. A client is returning home after arthroscopy of the shoulder. The nurse should tell the client:

• A. To resume full activity the next day
• B. Not to eat or drink anything until the next morning
• C. To keep the shoulder completely immobilized for the rest of the day
• D. To report to the physician the development of fever or redness and heat at the site

Correct answer: D

Rationale: After arthroscopy, it is important for the client to report any signs of infection, such as the development of fever or redness and heat at the site, to the physician promptly. Options A, B, and C are incorrect. The client should not resume full activity the next day as rest and limited movement are usually recommended post-arthroscopy. It is not necessary to withhold food or fluids until the next morning; the client may resume the usual diet immediately unless otherwise instructed. While immobilization may be recommended for a period, keeping the shoulder completely immobilized for the rest of the day is not typically necessary post-arthroscopy.

3. A client with renal insufficiency and a low red blood cell count asks, 'Is my anemia related to the renal insufficiency?' How should the nurse respond?

• A. Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
• B. Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density.
• C. Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.
• D. Kidney insufficiency inhibits active transportation of red blood cells throughout the blood.

Correct answer: C

Rationale: The correct answer is C. Erythropoietin is produced in the kidney and is released in response to decreased oxygen tension in the renal blood supply. Erythropoietin stimulates red blood cell production in the bone marrow. Anemia in renal insufficiency is often due to decreased erythropoietin production. Anemia and renal insufficiency are not manifestations of vitamin D deficiency as stated in choice B. Choice A is incorrect as erythropoietin does not increase blood flow to the kidneys. Choice D is incorrect because kidney insufficiency does not inhibit active transportation of red blood cells throughout the blood; rather, it affects erythropoietin production and subsequent red blood cell formation.

4. A client with autosomal dominant polycystic kidney disease (ADPKD) asks, “Will my children develop this disease?” How should the nurse respond?

• A. No genetic link is known, so your children are not at increased risk.
• B. Your sons will develop this disease because it has a sex-linked gene.
• C. Only if both you and your spouse are carriers of this disease.
• D. Each of your children has a 50% risk of having ADPKD.

Correct answer: D

Rationale: Children whose parent has the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease. ADPKD is transmitted as an autosomal dominant trait and therefore is not gender-specific. Both parents do not need to have this disorder. Choice A is incorrect because ADPKD has a known genetic link and a definitive mode of inheritance. Choice B is incorrect as ADPKD is not sex-linked but autosomal dominant. Choice C is incorrect because ADPKD follows an autosomal dominant inheritance pattern and does not require both parents to be carriers for the child to inherit the disease.

5. A client has just returned to the nursing unit after bronchoscopy. To which intervention should the nurse give priority?

• A. Assessing the client for the return of the gag reflex
• B. Administering pain medication
• C. Encouraging copious fluid intake
• D. Ambulating the client

Correct answer: A

Rationale: After bronchoscopy, the priority intervention for the nurse is to assess the client for the return of the gag reflex. This assessment is crucial to ensure the client's safety and prevent aspiration. Keeping the client on nothing-by-mouth status until the gag reflex returns is essential. Administering pain medication, encouraging fluid intake, and ambulating the client are important interventions but assessing the gag reflex takes precedence due to the risk of aspiration post-bronchoscopy.

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