Nursing Elites

1. A 30-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?

• A. Type 1 diabetes mellitus
• B. Type 2 diabetes mellitus
• C. Diabetes insipidus
• D. Hyperthyroidism

Correct answer: A

Rationale: The clinical presentation of a 30-year-old woman with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria is highly suggestive of type 1 diabetes mellitus. Type 1 diabetes mellitus is characterized by autoimmune destruction of pancreatic beta cells, leading to insulin deficiency and subsequent hyperglycemia. The presence of ketonuria indicates the breakdown of fats for energy due to the lack of insulin. In contrast, type 2 diabetes mellitus typically presents with gradual onset and is often associated with insulin resistance rather than absolute insulin deficiency. Diabetes insipidus is characterized by polyuria and polydipsia but is not associated with hyperglycemia or ketonuria. Hyperthyroidism may present with symptoms like fatigue but does not typically cause hyperglycemia or ketonuria.

2. A primipara at 38-weeks gestation is admitted to labor and delivery for a biophysical profile (BPP). The nurse should prepare the client for what procedures?

• A. Chorionic villus sampling under ultrasound.
• B. Amniocentesis and fetal monitoring.
• C. Ultrasonography and nonstress test.
• D. Oxytocin challenge test and fetal heart rate monitoring.

Correct answer: C

Rationale: A biophysical profile (BPP) is a prenatal test that assesses the well-being of the fetus. It typically includes ultrasonography to evaluate fetal movements, muscle tone, breathing movements, and amniotic fluid volume. Additionally, a nonstress test is performed to monitor the fetal heart rate in response to its movements. These tests help in determining the overall health and viability of the fetus, making them essential components of prenatal care for assessing fetal well-being.

3. A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?

• A. Aspirin.
• B. Allopurinol (Zyloprim).
• C. Colchicine.
• D. Probenecid (Benemid).

Correct answer: C

Rationale: During an acute gout attack, the healthcare provider is likely to prescribe colchicine. Colchicine is commonly used to treat acute gout attacks because it works by reducing inflammation and alleviating pain associated with the condition. It is important to note that aspirin is not recommended for gout treatment and may even exacerbate the symptoms. Allopurinol and probenecid are medications used for long-term management of gout by reducing uric acid levels in the blood, but they are not typically prescribed during an acute attack. Therefore, colchicine is the most appropriate medication for managing an acute gout attack.

4. A male client in the day room becomes increasingly angry and aggressive when denied a day-pass. Which action should the nurse implement?

• A. Tell him he can have a day pass if he calms down.
• B. Put the client's behavior on extinction.
• C. Decrease the volume on the television set.
• D. Instruct the client to sit down and be quiet.

Correct answer: D

Rationale: Instructing the client to sit down and be quiet is a direct and assertive approach that can help de-escalate the situation safely. It sets clear boundaries and expectations for the client's behavior, which may help reduce agitation and aggression in this scenario. Offering a day pass if the client calms down (Choice A) might reinforce the aggressive behavior. Putting the client's behavior on extinction (Choice B) involves not reinforcing the behavior, but it may not directly address the immediate safety concern. Decreasing the volume on the television set (Choice C) does not address the client's behavior directly and may not effectively manage the escalating situation.

5. In acute pancreatitis, a client experiencing severe abdominal pain should have which enzyme level closely monitored?

• A. Serum amylase.
• B. Serum sodium.
• C. Serum calcium.
• D. Serum potassium.

Correct answer: A

Rationale: In acute pancreatitis, serum amylase levels should be closely monitored. Elevated serum amylase levels are a key diagnostic marker for acute pancreatitis, aiding in the assessment and management of the patient's condition. Monitoring serum sodium, calcium, or potassium levels is not typically associated with acute pancreatitis and would not provide relevant information for this specific condition.

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