Nursing Elites

1. The healthcare provider is assessing a client with hypothyroidism. Which of the following clinical findings would the healthcare provider expect?

• A. Tachycardia
• B. Weight loss
• C. Cold intolerance
• D. Diaphoresis

Correct answer: C

Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a reduced ability to regulate body temperature. As a result, individuals with hypothyroidism often feel cold, especially in their extremities. Tachycardia (A) is more commonly associated with hyperthyroidism due to the increased metabolic rate. Weight loss (B) is also a typical finding in hyperthyroidism, as the body burns calories at a faster rate. Diaphoresis (D), excessive sweating, is not a typical symptom of hypothyroidism.

2. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?

• A. The client with colitis
• B. The client with Cushing's syndrome
• C. The client who has been overusing laxatives
• D. The client who has sustained a traumatic burn

Correct answer: D

Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.

3. A healthcare professional is reviewing the medication orders for a client with hypothyroidism. Which of the following medications should the healthcare professional question?

• A. Levothyroxine
• B. Amiodarone
• C. Calcium supplements
• D. Aspirin

Correct answer: B

Rationale: The correct answer is B: Amiodarone. Amiodarone can affect thyroid function and potentially worsen hypothyroidism, so its use should be carefully considered or questioned in clients with this condition. Levothyroxine (Choice A) is the mainstay therapy for hypothyroidism and should not be questioned in this scenario. Calcium supplements (Choice C) are not typically contraindicated in clients with hypothyroidism and may be needed if there is a deficiency. Aspirin (Choice D) is not directly related to thyroid function and is not a medication that would typically be questioned in a client with hypothyroidism.

4. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.

5. When instructing the female client diagnosed with hyperparathyroidism about diet, Nurse Gina should stress the importance of which of the following?

• A. Restricting fluids
• B. Restricting sodium
• C. Forcing fluids
• D. Restricting potassium

Correct answer: C

Rationale: The correct answer is C: Forcing fluids. Nurse Gina should stress the importance of forcing fluids to help prevent kidney stones and hypercalcemia in clients with hyperparathyroidism. Restricting fluids (choice A) is not recommended as dehydration can worsen the condition. Restricting sodium (choice B) is not directly related to the management of hyperparathyroidism. Restricting potassium (choice D) is not typically necessary in hyperparathyroidism unless hyperkalemia is present.

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