Nursing Elites

1. What signs/symptoms would the nurse expect to find in the client diagnosed with an insulinoma?

• A. Nervousness, jitteriness, and diaphoresis
• B. Flushed skin, dry mouth, and tented skin turgor
• C. Polyuria, polydipsia, polyphagia
• D. Hypertension, tachycardia, and feeling hot

Correct answer: A

Rationale: The correct answer is A: 'Nervousness, jitteriness, and diaphoresis.' Insulinomas cause hypoglycemia due to excessive insulin production, leading to symptoms such as nervousness (from the sympathetic response to hypoglycemia), jitteriness, and diaphoresis (sweating). Choices B, C, and D are incorrect. Flushed skin, dry mouth, and tented skin turgor (Choice B) are not typical signs of insulinoma. Polyuria, polydipsia, and polyphagia (Choice C) are classic symptoms of diabetes mellitus, not insulinoma. Hypertension, tachycardia, and feeling hot (Choice D) are more indicative of hyperthyroidism or a hypermetabolic state, rather than an insulinoma presentation.

2. The nurse is teaching a community class to people with Type 2 diabetes mellitus. Which explanation would explain the development of Type 2 diabetes?

• A. The islet cells in the pancreas stop producing insulin
• B. The client eats too many foods that are high in sugar
• C. The pituitary gland does not produce vasopressin
• D. The cells become resistant to the circulating insulin

Correct answer: D

Rationale: The correct answer is D. In Type 2 diabetes, the primary issue is insulin resistance, where cells do not respond effectively to insulin. Choice A is incorrect because in Type 1 diabetes, the islet cells in the pancreas stop producing insulin. Choice B is not directly related to the development of Type 2 diabetes but rather to its management. Choice C is incorrect as it refers to a dysfunction in vasopressin production, which is not related to Type 2 diabetes.

3. During a respiratory assessment, the nurse is determining respirations per minute. Which factor(s) generally affect the character of respirations? Select all that apply.

• A. Anxiety
• B. Exercise
• C. Smoking
• D. A, B

Correct answer: D

Rationale: The correct answer is D. Anxiety and exercise can significantly alter the character of respirations, increasing the rate and depth. Smoking primarily affects the health of the respiratory system in the long term but may not immediately impact the character of respirations. Therefore, choice C is incorrect. Choices A and B are correct as anxiety and exercise can lead to changes in the rate and depth of respirations.

4. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and noted that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s stated intent to leave the hospital. This action is crucial as it ensures that the client’s care and safety are appropriately managed. Option A is not the best choice as involving the family to persuade the client may not address the client's underlying concerns. Option B is incorrect because having the client sign self-discharge papers without further assessment is not appropriate. Option C is also incorrect as the client's request for treatment does not prevent them from leaving if they are deemed competent to make that decision.

5. What are three major causes of atherosclerosis?

• A. Hyperthyroidism, underweight, and poor appetite
• B. High blood cholesterol, high blood pressure, and cigarette smoking
• C. Constipation, peptic ulcer disease, and pancreatitis
• D. Kidney failure, edema, and sodium retention

Correct answer: B

Rationale: The correct answer is B: High blood cholesterol, high blood pressure, and cigarette smoking are three major causes of atherosclerosis. Atherosclerosis is mainly attributed to the buildup of cholesterol-rich plaques in the arteries, high blood pressure causing damage to the arterial walls, and the harmful effects of cigarette smoking on blood vessels. Choices A, C, and D are incorrect because they do not directly relate to the primary causes of atherosclerosis.

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