Nursing Elites

1. The nurse is caring for a client with diabetes insipidus. Which of the following laboratory findings should the nurse monitor?

• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: In diabetes insipidus, there is excessive excretion of water leading to dehydration. Monitoring serum sodium levels is crucial because these clients often experience hypernatremia (elevated serum sodium levels) due to the loss of relatively more water than sodium, resulting in a sodium concentration imbalance. While monitoring serum potassium, calcium, and magnesium levels is also important in various conditions, they are not the primary focus in diabetes insipidus.

2. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?

• A. Hypernatremia
• B. Hypotension
• C. Decreased urine output
• D. Polyuria

Correct answer: C

Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.

3. Which of the following best describes the nurse's responsibility in obtaining informed consent?

• A. The nurse is responsible for ensuring that the patient understands the procedure and has the opportunity to ask questions.
• B. The nurse should ensure that the patient signs the consent form before the procedure begins.
• C. The nurse is responsible for witnessing the patient sign the consent form and documenting the event.
• D. The nurse should delegate the task of obtaining informed consent to another healthcare provider.

Correct answer: A

Rationale: The correct answer is A. Informed consent is a process where the healthcare provider, in this case, the nurse, ensures that the patient understands the procedure, risks, benefits, and alternatives before they agree to it. The nurse plays a crucial role in facilitating this understanding by explaining the information in a clear and understandable manner and providing the patient with the opportunity to ask questions. Choice B is incorrect because merely obtaining the patient's signature on the consent form does not ensure that the patient truly understands what they are consenting to. Choice C is not fully accurate as the nurse's role goes beyond just witnessing the signature; it involves actively ensuring the patient's comprehension. Choice D is incorrect as the responsibility of obtaining informed consent should not be delegated to another healthcare provider, as it is the nurse's duty to ensure proper communication and understanding with the patient.

4. A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which of the following interventions should be the nurse's priority?

• A. Administer intravenous insulin
• B. Start an intravenous line and infuse normal saline
• C. Monitor serum potassium levels
• D. Obtain an arterial blood gas (ABG)

Correct answer: B

Rationale: The correct answer is to start an intravenous line and infuse normal saline. In diabetic ketoacidosis (DKA), the priority intervention is fluid resuscitation with normal saline to restore intravascular volume and improve perfusion. Administering insulin without first addressing dehydration and electrolyte imbalances can lead to further complications. Monitoring serum potassium levels and obtaining an arterial blood gas (ABG) are important aspects of DKA management but come after initial fluid resuscitation.

5. The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?

• A. Increase your sodium intake during periods of stress.
• B. Avoid all types of exercise.
• C. Decrease your fluid intake to prevent fluid overload.
• D. Stop corticosteroid therapy once symptoms improve.

Correct answer: A

Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.

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