Nursing Elites

1. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.

2. Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?

• A. Leadership
• B. Business sense
• C. Clinical expertise
• D. Financial management

Correct answer: B

Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.

3. Which of the following is a priority nursing diagnosis for a client with Addison's disease?

• A. Fluid volume deficit
• B. Risk for infection
• C. Imbalanced nutrition: Less than body requirements
• D. Disturbed body image

Correct answer: A

Rationale: The priority nursing diagnosis for a client with Addison's disease is 'Fluid volume deficit.' Addison's disease is characterized by adrenal insufficiency, resulting in decreased aldosterone production. Aldosterone plays a key role in sodium and water retention in the body. With its deficiency, there is an increased risk of dehydration and electrolyte imbalance, leading to fluid volume deficit. While infection risk, nutrition issues, and body image disturbances are also important considerations for holistic care, addressing the fluid volume deficit takes precedence due to the immediate physiological impact on the client's health and well-being.

4. A client with hypothyroidism is at risk for which of the following complications?

• A. Thyroid storm
• B. Myxedema coma
• C. Cushing's syndrome
• D. Diabetic ketoacidosis

Correct answer: B

Rationale: Myxedema coma is a severe, life-threatening complication that can occur in individuals with untreated or inadequately treated hypothyroidism. It is characterized by extreme hypothyroidism leading to decreased mental status, hypothermia, bradycardia, and respiratory depression. Thyroid storm (Choice A) is a severe complication of hyperthyroidism, not hypothyroidism. Cushing's syndrome (Choice C) results from prolonged exposure to high levels of cortisol, not related to hypothyroidism. Diabetic ketoacidosis (Choice D) is a complication of uncontrolled diabetes, not directly associated with hypothyroidism.

5. Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

• A. Tetanic contractions
• B. Neck vein distention
• C. Weight loss
• D. Polyuria

Correct answer: B

Rationale: Neck vein distention is a sign of fluid overload, a complication of SIADH due to water retention. Tetanic contractions (Choice A) are not typically associated with SIADH. Weight loss (Choice C) is not a common complication of SIADH, as patients often experience fluid retention and weight gain. Polyuria (Choice D) is also not a typical sign of SIADH, as the condition is characterized by water retention and decreased urine output.

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