Nursing Elites

1. 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.

2. The healthcare provider is assessing a client with suspected diabetes insipidus. Which of the following clinical manifestations would support this diagnosis?

• A. Polyuria and polydipsia
• B. Hypertension and bradycardia
• C. Weight gain and edema
• D. Oliguria and thirst

Correct answer: A

Rationale: Polyuria (excessive urination) and polydipsia (excessive thirst) are classic clinical manifestations of diabetes insipidus. In this condition, there is a deficiency of antidiuretic hormone, leading to the inability of the kidneys to concentrate urine effectively, resulting in increased urine output (polyuria) and consequent thirst (polydipsia). Hypertension and bradycardia (Choice B) are not typical findings in diabetes insipidus. Weight gain and edema (Choice C) are more indicative of conditions such as heart failure or nephrotic syndrome. Oliguria (decreased urine output) and thirst (Choice D) are contradictory symptoms to what is seen in diabetes insipidus.

3. A nurse manager works hard to keep employee morale high with the thought that this will lead to effective employees doing the best work they can. Which of the following theories does this best describe?

• A. Theory X
• B. Theory Y
• C. Servant leadership
• D. Scientific management

Correct answer: B

Rationale: Theory Y, as proposed by Douglas McGregor, emphasizes that employees are intrinsically motivated and seek responsibility. It suggests that high morale leads to high productivity, aligning with the nurse manager's actions. Theory X, on the other hand, assumes employees are inherently lazy and need to be closely monitored and controlled. Servant leadership focuses on serving others first and prioritizing their needs, which is not directly related to the scenario described. Scientific management, developed by Frederick Taylor, emphasizes efficiency and standardization through systematic study and organizational control, which is not the primary focus of the nurse manager's approach to boosting employee morale.

4. To be effective, a nurse manager needs both managerial and leadership skills. Interpersonal activities have many concerns that overlap both leaders and managers. However, some interpersonal activities are needed by nurse managers, but are not specific duties of leaders. Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?

• A. Coaching
• B. Resource allocation
• C. Planning for the future
• D. Monitoring

Correct answer: B

Rationale: Resource allocation is an interpersonal activity specific to nurse managers because it involves managing the distribution of resources within the healthcare environment, which is not necessarily a duty for all leaders. While coaching, planning for the future, and monitoring are important skills for both leaders and managers, resource allocation is a task that is more specific to the managerial role of nurse managers.

5. Which of the following is a priority nursing diagnosis for a client with Addison's disease?

• A. Fluid volume deficit
• B. Risk for infection
• C. Imbalanced nutrition: Less than body requirements
• D. Disturbed body image

Correct answer: A

Rationale: The priority nursing diagnosis for a client with Addison's disease is 'Fluid volume deficit.' Addison's disease is characterized by adrenal insufficiency, resulting in decreased aldosterone production. Aldosterone plays a key role in sodium and water retention in the body. With its deficiency, there is an increased risk of dehydration and electrolyte imbalance, leading to fluid volume deficit. While infection risk, nutrition issues, and body image disturbances are also important considerations for holistic care, addressing the fluid volume deficit takes precedence due to the immediate physiological impact on the client's health and well-being.

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