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. Which of the following is true about nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the moral character of nurses.
• C. Nursing ethics focus on the experiences and needs of patients.
• D. Nursing ethics focus on the ethical principles governing healthcare organizations.

Correct answer: B

Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.

3. The client with type 2 DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:

• A. Increased risk of heart disease and stroke.
• B. Improved wound healing.
• C. Reduced need for medication.
• D. Decreased risk of infection.

Correct answer: A

Rationale: Uncontrolled blood glucose levels are associated with an increased risk of cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, leading to atherosclerosis, which can increase the likelihood of heart disease and stroke. Improved wound healing (choice B) is not a consequence of uncontrolled blood glucose levels; in fact, high blood sugar levels can impair wound healing. Reduced need for medication (choice C) is inaccurate because uncontrolled blood glucose usually necessitates more medication to manage the condition. Decreased risk of infection (choice D) is also misleading as high blood glucose levels can compromise the immune system, making individuals more susceptible to infections.

4. The healthcare provider is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings is most consistent with this condition?

• A. Increased serum sodium
• B. Decreased urine specific gravity
• C. Decreased serum osmolality
• D. Increased serum potassium

Correct answer: C

Rationale: The correct answer is C: Decreased serum osmolality. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. The dilution of sodium results in decreased serum osmolality. Option A is incorrect because SIADH causes hyponatremia, resulting in decreased serum sodium levels. Option B is incorrect because SIADH leads to concentrated urine with increased urine specific gravity. Option D is incorrect as SIADH does not typically affect serum potassium levels.

5. What is the approximate duration of action for intermediate-acting insulins like NPH?

• A. 6-8 hours.
• B. 10-14 hours.
• C. 16-20 hours.
• D. 24-28 hours.

Correct answer: C

Rationale: The correct answer is C: '16-20 hours.' Intermediate-acting insulins like NPH typically have a duration of action of approximately 16-20 hours. This prolonged action makes them effective in managing blood glucose levels over an extended period. Choices A, B, and D are incorrect because they do not align with the typical duration of action for intermediate-acting insulins. Choice A (6-8 hours) is too short, choice B (10-14 hours) is also shorter than the typical duration, and choice D (24-28 hours) is too long for intermediate-acting insulins like NPH.

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