Nursing Elites

1. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

• A. Increasing saturated fat intake and fasting in the afternoon
• B. Increasing intake of vitamins B and D and taking iron supplements
• C. Eating a candy bar if lightheadedness occurs
• D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting

Correct answer: D

Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.

2. Which nursing diagnosis takes the highest priority for a female client with hyperthyroidism?

• A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
• B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
• C. Body image disturbance related to weight gain and edema
• D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Correct answer: D

Rationale: The correct answer is D: Imbalanced nutrition: Less than body requirements related to thyroid hormone excess. In hyperthyroidism, increased metabolic rate leads to increased nutritional needs, causing weight loss and muscle wasting. Therefore, addressing imbalanced nutrition due to excessive thyroid hormone is a priority. Choice A is incorrect as hyperthyroidism typically leads to weight loss, not weight gain. Choice B is less of a priority as skin issues are secondary to the metabolic disturbances caused by hyperthyroidism. Choice C, body image disturbance, is important but addressing the client's nutritional needs should take precedence to prevent further complications.

3. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperkalemia

Correct answer: A

Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.

4. A client with diabetes mellitus is scheduled for surgery. The nurse should prioritize which of the following preoperative actions?

• A. Administer a full dose of insulin before surgery
• B. Hold all oral hypoglycemic agents the day before surgery
• C. Monitor blood glucose levels closely before surgery
• D. Instruct the client to avoid all fluids the morning of surgery

Correct answer: C

Rationale: Monitoring blood glucose levels closely before surgery is the priority for a client with diabetes mellitus. This allows for early detection of any abnormalities and helps prevent hypo- or hyperglycemia complications that can arise during the perioperative period. Option A is incorrect because insulin dosing should be individualized based on the client's current blood glucose levels and the surgical plan. Option B is incorrect as abruptly holding oral hypoglycemic agents can lead to uncontrolled blood glucose levels. Option D is incorrect as adequate fluid intake is important for the client's hydration status and overall well-being before surgery.

5. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

• A. Prefers to take insulin orally.
• B. Has type 2 diabetes.
• C. Has type 1 diabetes.
• D. Is pregnant and has type 2 diabetes.

Correct answer: B

Rationale: Oral antidiabetic agents are specifically designed for type 2 diabetes mellitus. Type 1 diabetes requires insulin therapy as the primary treatment due to the absence of endogenous insulin production. Therefore, these medications are not effective for individuals with type 1 diabetes like the male client in this scenario. Choice A is incorrect as oral antidiabetic agents are not about preference but rather about treatment efficacy. Choice D is incorrect as being pregnant does not impact the effectiveness of oral antidiabetic agents; they are primarily indicated for type 2 diabetes.

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