Nursing Elites

1. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?

• A. Administer intravenous fluids
• B. Provide a warming blanket
• C. Administer levothyroxine intravenously
• D. Place the client in Trendelenburg position

Correct answer: C

Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.

2. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

3. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

• A. Infusing I.V. fluids rapidly as ordered
• B. Encouraging increased oral intake
• C. Restricting fluids
• D. Administering glucose-containing I.V. fluids as ordered

Correct answer: C

Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.

4. The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?

• A. Decreased blood glucose levels
• B. Decreased urine ketones
• C. Increased serum bicarbonate
• D. Increased anion gap

Correct answer: D

Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.

5. A client with diabetes mellitus is being educated on the signs and symptoms of hypoglycemia. Which of the following symptoms should the client be instructed to report immediately?

• A. Shakiness
• B. Sweating
• C. Confusion
• D. Increased thirst

Correct answer: C

Rationale: Confusion is a critical symptom of hypoglycemia that indicates the brain is not receiving enough glucose, potentially leading to serious complications like unconsciousness or seizures. Immediate reporting of confusion is essential for prompt intervention to prevent worsening of hypoglycemia. Shakiness and sweating are early warning signs of hypoglycemia but may not always require immediate intervention. Increased thirst is a symptom commonly associated with hyperglycemia rather than hypoglycemia.

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