Nursing Elites

1. The client with DM who is taking insulin develops a fever and becomes confused. Which action should the nurse take first?

• A. Check the client's blood glucose level.
• B. Administer a fever-reducing medication.
• C. Give the client fluids to drink.
• D. Notify the health care provider.

Correct answer: A

Rationale: In a client with diabetes mellitus (DM) taking insulin, the development of fever and confusion may indicate hyperglycemia or diabetic ketoacidosis. Checking the blood glucose level is the priority action in this situation. This will help determine if the symptoms are related to high blood sugar levels, guiding further interventions. Administering a fever-reducing medication (choice B) addresses only the symptom of fever and does not address the underlying cause. Providing fluids to drink (choice C) is important but should come after addressing the potential hyperglycemia or diabetic ketoacidosis. Notifying the health care provider (choice D) can be important, but immediate action to evaluate and manage the client's condition should precede contacting the provider.

2. The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?

• A. Seafood
• B. Spinach
• C. Bananas
• D. Oatmeal

Correct answer: A

Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.

3. A client with Addison's disease is at risk for which of the following complications?

• A. Hypertension
• B. Hypovolemia
• C. Hypernatremia
• D. Hypokalemia

Correct answer: B

Rationale: A client with Addison's disease is at risk for hypovolemia. Addison's disease is characterized by adrenal insufficiency, particularly cortisol and aldosterone deficiency. Aldosterone deficiency leads to impaired sodium and water retention, resulting in decreased blood volume and hypovolemia. This condition can cause hypotension, not hypertension (Choice A), as reduced blood volume leads to decreased pressure. Hypernatremia (Choice C) is unlikely in Addison's disease because of the loss of sodium along with water in hypovolemia. Hypokalemia (Choice D) can occur due to aldosterone deficiency, but it is not the primary complication associated with Addison's disease.

4. A good relationship between a leader and a follower enables the follower to 'manage up.' Which of the following describes the best way for a follower to 'manage up'?

• A. Provide feedback to the unit manager when the manager asks for it.
• B. Assist your manager in capitalizing on his or her strengths and weaknesses.
• C. When a follower works with a manager with poor leadership skills, it is best to transfer to a different unit.
• D. Show respect and appreciation for the manager, even when speaking with coworkers.

Correct answer: D

Rationale: Managing up involves building a positive relationship with one's manager by showing respect and appreciation. Choice A is not the best way to manage up as it only focuses on providing feedback when asked, rather than proactively showing respect. Choice B is incorrect as it suggests assisting the manager in capitalizing on their strengths and weaknesses, which is more about helping the manager rather than managing up. Choice C is not the best option as transferring to a different unit should not be the first step in managing up, as it does not address the relationship with the current manager. Therefore, the best way for a follower to manage up is by showing respect and appreciation for the manager, even in conversations with coworkers.

5. Which of the following best describes the nurse's role in patient education?

• A. The nurse is responsible for providing patients with information they need to make informed decisions about their care.
• B. The nurse provides education to the patient and their family to help them understand the care plan and make informed decisions.
• C. The nurse is responsible for providing patients with written materials to help them understand their condition and treatment options.
• D. The nurse provides patients with verbal and written instructions on how to manage their care at home.

Correct answer: A

Rationale: The correct answer is A. The nurse's role in patient education involves providing patients with the necessary information to make informed decisions about their care. This includes explaining treatment options, potential risks and benefits, and answering any questions the patient may have. Choice B is incorrect because while nurses do educate patients and families, the primary focus is on empowering patients to make informed decisions. Choice C is incorrect as providing written materials is a part of patient education but not the sole responsibility of the nurse. Choice D is incorrect because while nurses do provide instructions on managing care at home, patient education goes beyond just the home care aspect to encompass a broader understanding of the patient's condition and treatment.

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