Nursing Elites

1. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperphosphatemia

Correct answer: B

Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.

2. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?

• A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
• B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
• C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
• D. It regulates the threshold for water reabsorption in the kidneys.

Correct answer: C

Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.

3. To be effective, a nurse manager needs both managerial and leadership skills. Interpersonal activities have many concerns that overlap both leaders and managers. However, some interpersonal activities are needed by nurse managers, but are not specific duties of leaders. Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?

• A. Coaching
• B. Resource allocation
• C. Planning for the future
• D. Monitoring

Correct answer: B

Rationale: Resource allocation is an interpersonal activity specific to nurse managers because it involves managing the distribution of resources within the healthcare environment, which is not necessarily a duty for all leaders. While coaching, planning for the future, and monitoring are important skills for both leaders and managers, resource allocation is a task that is more specific to the managerial role of nurse managers.

4. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.

5. A nurse is preparing to administer NPH insulin to a client with DM. The nurse notes that the NPH insulin vial is cloudy. The nurse should:

• A. Obtain a new vial of NPH insulin.
• B. Draw up the cloudy insulin as ordered.
• C. Shake the vial vigorously before drawing up the insulin.
• D. Warm the insulin to room temperature before administration.

Correct answer: B

Rationale: The correct answer is to draw up the cloudy insulin as ordered. NPH insulin is inherently cloudy due to its suspension of insulin crystals. Shaking the vial vigorously can lead to denaturation of the insulin molecules, altering its efficacy. Warming NPH insulin is not necessary as it can cause breakdown of insulin molecules. The nurse should gently roll the vial between hands to mix it before drawing it up to ensure an even distribution of insulin in the suspension.

Similar Questions