Nursing Elites

1. Which of the following laboratory values should the nurse monitor in a client with Cushing's syndrome?

• A. Blood glucose levels
• B. Serum calcium levels
• C. Serum potassium levels
• D. Serum sodium levels

Correct answer: A

Rationale: The correct answer is A: Blood glucose levels. In Cushing's syndrome, there is excess cortisol in the body which leads to increased blood glucose levels due to its effect on glucose metabolism. Elevated blood glucose levels are a common finding in individuals with Cushing's syndrome. Monitoring blood glucose levels is crucial as it helps in assessing and managing hyperglycemia in these patients. Choice B, serum calcium levels, is not typically a priority in monitoring for Cushing's syndrome. While abnormalities in calcium levels can occur in some endocrine disorders, hypercalcemia is not a hallmark of Cushing's syndrome. Choice C, serum potassium levels, and Choice D, serum sodium levels, are not directly associated with Cushing's syndrome. While electrolyte imbalances can occur in various conditions, they are not specifically linked to Cushing's syndrome as blood glucose levels are.

2. The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?

• A. Increase intake of dairy products and green leafy vegetables
• B. Avoid foods high in calcium
• C. Consume a high-sodium diet
• D. Limit fluid intake to prevent fluid overload

Correct answer: A

Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.

3. A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?

• A. The client taking diuretics
• B. The client with renal failure
• C. The client with an ileostomy
• D. The client who requires gastrointestinal suctioning

Correct answer: B

Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.

4. The client has undergone a thyroidectomy. Which of the following symptoms would indicate a potential complication?

• A. Bradycardia
• B. Tachycardia
• C. Hyperreflexia
• D. Hypocalcemia

Correct answer: D

Rationale: Hypocalcemia is a potential complication of thyroidectomy as it may occur if the parathyroid glands, responsible for calcium regulation, are inadvertently removed or damaged during the procedure. Bradycardia (slow heart rate) is not typically associated with thyroidectomy complications. Tachycardia (fast heart rate) is more commonly seen in hyperthyroidism. Hyperreflexia (exaggerated reflex responses) is not a typical complication of thyroidectomy.

5. 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.

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