Nursing Elites

1. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?

• A. Encourage increased fluid intake
• B. Administer hypertonic saline
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.

2. The client with type 2 DM is learning to manage blood glucose levels. When should the client monitor blood glucose?

• A. Only when feeling unwell.
• B. Only before meals.
• C. Before meals and at bedtime.
• D. Only after meals.

Correct answer: C

Rationale: The correct answer is to monitor blood glucose before meals and at bedtime. This timing allows the client to assess fasting levels and make informed decisions about mealtime insulin or medication doses. Monitoring only when feeling unwell (choice A) is not sufficient for proper glucose management as it may miss important trends. Monitoring only before meals (choice B) is helpful but does not provide a complete picture of the client's glucose control throughout the day. Monitoring only after meals (choice D) is less beneficial than monitoring before meals as it does not capture fasting levels. Therefore, monitoring before meals and at bedtime (choice C) is the most comprehensive approach to maintain good glucose control and prevent complications.

3. The client with newly diagnosed diabetes mellitus is receiving education from the nurse on managing blood glucose levels. Which statement indicates a need for further teaching?

• A. I will monitor my blood glucose levels regularly.
• B. I can eat whatever I want as long as I take my medication.
• C. I should exercise regularly to help control my blood sugar.
• D. I will rotate my injection sites to avoid tissue damage.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because it suggests that the client can eat whatever they want as long as they take their medication, which is incorrect. Clients with diabetes mellitus need to follow a healthy and balanced diet in addition to taking their medication to effectively manage blood glucose levels. Choices A, C, and D are correct statements for managing diabetes. Monitoring blood glucose levels regularly, engaging in regular exercise to help control blood sugar, and rotating injection sites to avoid tissue damage are all important aspects of diabetes management.

4. A healthcare provider is educating a client with DM on recognizing symptoms of hypoglycemia. Which symptom should the healthcare provider mention?

• A. Increased thirst
• B. Frequent urination
• C. Sweating
• D. Weight loss

Correct answer: C

Rationale: The correct symptom to mention when educating a client with diabetes mellitus (DM) on hypoglycemia is sweating. Sweating is a common symptom of hypoglycemia as it occurs due to the activation of the sympathetic nervous system in response to low blood sugar levels. Increased thirst (Choice A) and frequent urination (Choice B) are more indicative of hyperglycemia (high blood sugar) rather than hypoglycemia. Weight loss (Choice D) is not a typical symptom associated with hypoglycemia.

5. In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:

• A. Serum glucose level.
• B. Hair loss.
• C. Bone mineralization.
• D. Menstrual flow.

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's syndrome, there is excess cortisol production which can lead to hyperglycemia. Successful treatment of Cushing's syndrome aims to normalize cortisol levels, resulting in a decline in serum glucose levels. Choice B, hair loss, is not specifically associated with Cushing's syndrome or its treatment. Choice C, bone mineralization, is often compromised in Cushing's syndrome due to the effects of excess cortisol on bones; however, successful treatment would aim to improve bone health rather than decline it. Choice D, menstrual flow, is not directly linked to Cushing's syndrome or its treatment, so a decline in menstrual flow would not be an expected outcome of successful treatment.

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