Nursing Elites

1. The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?

• A. I should take my medication every day as prescribed.
• B. I need to avoid foods high in iodine.
• C. I can skip my medication on days when I feel fine.
• D. I should monitor my pulse regularly.

Correct answer: C

Rationale: Clients with hyperthyroidism should take their medication consistently and not skip doses, even if they feel well.

2. 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.

3. A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicates an inadequate understanding of the peak action of NPH insulin and exercise?

• A. The best time for me to exercise is every afternoon.
• B. The best time for me to exercise is right after I eat.
• C. The best time for me to exercise is after breakfast.
• D. The best time for me to exercise is after my morning snack.

Correct answer: A

Rationale: Exercising in the afternoon may coincide with the peak action of NPH insulin, increasing the risk of hypoglycemia. The peak action of NPH insulin typically occurs 4-12 hours after administration, so exercising during this time can further lower blood sugar levels. Choices B, C, and D are better options as they suggest exercising at times that are less likely to overlap with the peak insulin action, reducing the risk of hypoglycemia.

4. A healthcare professional is focusing on improving the ability to multitask without losing focus and to turn problems into opportunities. Which of the following leadership theories describes the professional's focus?

• A. Emotional intelligence
• B. Motivation theory
• C. Situational leadership theory
• D. Transformational leadership theory

Correct answer: B

Rationale: Motivation theory explains that individuals act based on what they want to achieve, focusing on goals and desires. In this scenario, the healthcare professional's emphasis on improving multitasking skills and problem-solving aligns with the essence of motivation theory. Emotional intelligence primarily pertains to understanding and managing emotions, not specifically related to multitasking and problem-solving. Situational leadership theory emphasizes adapting leadership styles based on the situation and followers, not directly related to individual focus improvement. Transformational leadership theory focuses on inspiring and motivating followers to achieve common goals rather than individual task management and problem-solving skills.

5. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.

• A. Place the solution on an IV pump at the prescribed rate.
• B. Monitor blood glucose every twelve (12) hours.
• C. Weigh the client weekly, first thing in the morning.
• D. Change the IV tubing every three (3) days.

Correct answer: D

Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.

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