Nursing Elites

1. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?

• A. Weight loss
• B. Heat intolerance
• C. Bradycardia
• D. Diarrhea

Correct answer: C

Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.

2. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

• A. Fluid intake is less than 2,500 ml/day
• B. Urine output measures more than 200 ml/hour
• C. Blood pressure is 90/50 mm Hg
• D. The heart rate is 126 beats/minute

Correct answer: A

Rationale: The correct outcome indicating effective treatment of diabetes insipidus in a male client is a fluid intake of less than 2,500 ml/day. In diabetes insipidus, excessive urination causes increased fluid intake to compensate for the fluid loss. By effectively managing the condition, the client's fluid intake should decrease. Choices B, C, and D do not directly reflect the effectiveness of treatment for diabetes insipidus. Increased urine output (choice B) may indicate inadequate control of the condition, while low blood pressure (choice C) and a high heart rate (choice D) are not specific indicators of effective treatment for diabetes insipidus.

3. When implementing a new policy on the unit, what process should a nurse manager follow?

• A. The nurse manager should involve staff members in the decision-making process, gather input, and communicate the reasons for the policy change to ensure buy-in from the team.
• B. The nurse manager should implement the policy change immediately and monitor staff compliance to ensure that the new policy is being followed.
• C. The nurse manager should delegate the implementation of the policy change to a staff member and provide support as needed to ensure that the change is successful.
• D. The nurse manager should communicate the policy change to staff members, provide training as needed, and monitor the implementation process to ensure that the change is effective.

Correct answer: A

Rationale: When introducing a new policy on the unit, it is essential for the nurse manager to involve staff members in the decision-making process. This approach helps in gathering input and insights from the team, fostering a sense of ownership and commitment. By communicating the reasons behind the policy change, the nurse manager ensures transparency and promotes understanding among the staff, leading to buy-in and acceptance of the new policy. Choice B is incorrect because implementing a policy change without involving staff and explaining the rationale may lead to resistance or lack of understanding. Choice C is not ideal as delegation without active involvement and communication with the team may result in misunderstandings or incomplete implementation. Choice D lacks the crucial step of involving staff in the decision-making process, which is important for successful policy implementation and team engagement.

4. Working in a stressful work environment, nursing requires effective nurse managers. Which of the following skills is necessary for a nurse manager to be effective?

• A. Clinical knowledge
• B. Managerial skills
• C. Patient care coordination
• D. Human resource training

Correct answer: B

Rationale: Managerial skills are crucial for nurse managers to be effective. They need to possess skills such as problem-solving and decision-making to handle various challenges in the healthcare setting. Clinical knowledge (choice A) is important for direct patient care but may not be the primary focus of a manager's role. Patient care coordination (choice C) is vital, but managerial skills are more directly related to a nurse manager's effectiveness. Human resource training (choice D) is helpful but not as essential as managerial skills in ensuring effective leadership in a nursing environment.

5. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which 'related-to' phrase should the nurse add?

• A. Related to bone demineralization resulting in pathologic fractures
• B. Related to exhaustion secondary to an accelerated metabolic rate
• C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
• D. Related to tetany secondary to a decreased serum calcium level

Correct answer: A

Rationale: The correct answer is A: 'Related to bone demineralization resulting in pathologic fractures.' In chronic hyperparathyroidism, bone demineralization occurs due to the excessive release of parathyroid hormone, leading to increased calcium resorption from bones. This process weakens the bones, making the client prone to pathologic fractures. Choices B, C, and D are incorrect because they do not directly relate to the increased risk of injury associated with chronic hyperparathyroidism. Exhaustion, edema, dry skin, and tetany are not the primary risks for injury in this client population.

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