Nursing Elites

1. Nurse Troy is aware that the most appropriate nursing diagnosis for a client with Addison's disease is:

• A. Risk for infection
• B. Excessive fluid volume
• C. Urinary retention
• D. Hypothermia

Correct answer: A

Rationale: The most appropriate nursing diagnosis for a client with Addison's disease is 'Risk for infection.' Addison's disease is characterized by corticosteroid deficiency, which leads to immune suppression, making these clients more susceptible to infections. This diagnosis reflects the increased vulnerability of clients with Addison's disease to infections. Choices B, C, and D are incorrect because Addison's disease does not typically present with excessive fluid volume, urinary retention, or hypothermia as primary concerns.

2. The patient expects that a type 1 diabetic may receive ____ of their morning dose of insulin preoperatively:

• A. 10-20%.
• B. 25-40%.
• C. 50-60%.
• D. 85-90%.

Correct answer: B

Rationale: It is common practice to administer 25-40% of the morning dose of insulin preoperatively to prevent hypoglycemia during surgery. Giving a lower percentage (A) may not provide sufficient glycemic control, while higher percentages (C, D) can increase the risk of hypoglycemia during the surgical procedure.

3. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should Nurse Hans recognize as an adverse drug effect?

• A. Dysuria
• B. Leg cramps
• C. Tachycardia
• D. Blurred vision

Correct answer: C

Rationale: Tachycardia is a potential adverse effect of levothyroxine, indicating overmedication. Dysuria (painful urination) is not typically associated with levothyroxine. Leg cramps are not a common adverse effect of levothyroxine. Blurred vision is not a typical adverse effect of levothyroxine; instead, it may be a sign of other eye-related conditions or medication side effects.

4. Why is it important to control blood glucose levels in type 2 DM?

• A. Hypertension and kidney disease.
• B. Weight gain and obesity.
• C. Improved wound healing.
• D. Decreased cholesterol levels.

Correct answer: A

Rationale: Controlling blood glucose levels in type 2 DM is crucial to prevent complications. High blood glucose levels can lead to hypertension and kidney disease, as seen in diabetic nephropathy and diabetic nephropathy. These are common complications of uncontrolled diabetes. Weight gain and obesity (choice B) are influenced by factors such as diet and physical activity rather than blood glucose levels. Improved wound healing (choice C) is not directly related to blood glucose control but can be affected by it indirectly. Decreased cholesterol levels (choice D) are not a direct consequence of high blood glucose levels and are more related to dietary and lifestyle factors.

5. Nurse Noemi administers glucagon to her diabetic client and then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

• A. Oral anticoagulants
• B. Anabolic steroids
• C. Beta-adrenergic blockers
• D. Thiazide diuretics

Correct answer: A

Rationale: The correct answer is A: Oral anticoagulants. Glucagon may enhance the anticoagulant effect of oral anticoagulants, increasing the risk of bleeding. This interaction can be dangerous for the patient, leading to serious complications. Choices B, C, and D are incorrect because anabolic steroids, beta-adrenergic blockers, and thiazide diuretics do not typically interact adversely with glucagon. It is crucial for healthcare providers to be aware of potential drug interactions to ensure patient safety and optimal outcomes.

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