Nursing Elites

1. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

• A. Antidiuretic hormone (ADH)
• B. Thyroid-stimulating hormone (TSH)
• C. Follicle-stimulating hormone (FSH)
• D. Luteinizing hormone (LH)

Correct answer: A

Rationale: Diabetes insipidus is a condition characterized by a deficiency of antidiuretic hormone (ADH). ADH plays a crucial role in regulating water balance by controlling the amount of water reabsorbed by the kidneys. Options B, C, and D are incorrect as they are not associated with diabetes insipidus. TSH (thyroid-stimulating hormone) is responsible for regulating thyroid function, while FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are involved in reproductive functions.

2. 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.

3. Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which she receives 8 U of regular insulin. Nurse Vince should expect the dose's:

• A. Onset to be at 2 p.m. and its peak to be at 3 p.m.
• B. Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
• C. Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
• D. Onset to be at 4 p.m. and its peak to be at 6 p.m.

Correct answer: C

Rationale: The correct answer is C. Regular insulin typically has an onset of action within 30 minutes and peaks 2-4 hours after administration. Given that the insulin was administered at 2 p.m., the onset of action can be expected around 2:30 p.m., and the peak effect would occur between 4-6 p.m. Choice A is incorrect as the onset and peak are too close together for regular insulin. Choice B is incorrect because the onset time is too soon after administration. Choice D is incorrect as the onset time is too delayed for regular insulin.

4. Which of the following traits is characteristic of a caring leader?

• A. A caring leader serves first and leads second.
• B. A caring leader is aware of the feelings of others.
• C. The traits of a caring leader include respecting coworkers as individuals and empathizing with the needs and concerns of others.
• D. A caring leader is fair and honest.

Correct answer: C

Rationale: A caring leader is characterized by respecting coworkers as individuals and empathizing with their needs and concerns. Choice A is more about servant leadership rather than specifically about caring leadership. Choice B, while related to empathy, does not encompass the full spectrum of traits associated with a caring leader. Choice D, being fair and honest, is important in leadership but does not solely define a caring leader.

5. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?

• A. Administer intravenous fluids
• B. Provide a warming blanket
• C. Administer levothyroxine intravenously
• D. Place the client in Trendelenburg position

Correct answer: C

Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.

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