Nursing Elites

1. A 40-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 combination of symptoms including fatigue, polyuria, polydipsia, along with laboratory findings of hyperglycemia and ketonuria strongly suggest type 1 diabetes mellitus. In type 1 diabetes mellitus, there is a deficiency of insulin leading to high blood sugar levels (hyperglycemia) and the breakdown of fats producing ketones, causing ketonuria. Type 2 diabetes mellitus typically presents differently and is more common in older individuals. Diabetes insipidus is characterized by excessive thirst and urination due to a deficiency of antidiuretic hormone, distinct from the provided clinical scenario. Hyperthyroidism may present with some overlapping symptoms like fatigue, but it does not account for the specific laboratory findings of hyperglycemia and ketonuria seen in this case.

2. A client's healthcare provider has ordered a 'liver panel' in response to the client's development of jaundice. When reviewing the results of this laboratory testing, the nurse should expect to review what blood tests? Select one that doesn't apply.

• A. Alanine aminotransferase (ALT)
• B. C-reactive protein (CRP)
• C. Gamma-glutamyl transferase (GGT)
• D. Aspartate aminotransferase (AST)

Correct answer: B

Rationale: A 'liver panel' is a group of blood tests used to evaluate liver function. The components typically include ALT, GGT, and AST. While C-reactive protein (CRP) is a marker of inflammation and not part of a standard liver panel, it may be ordered for other diagnostic purposes.

3. What should the nurse include in patient teaching for a patient prescribed ceftriaxone for bacterial pneumonia?

• A. Take the medication as prescribed.
• B. Expect urine color changes.
• C. Complete the full course of the antibiotic.
• D. Avoid dairy products during treatment.

Correct answer: C

Rationale: When educating a patient prescribed ceftriaxone for bacterial pneumonia, it is crucial to emphasize completing the full course of the antibiotic. Completing the full course helps ensure the infection is completely eradicated and reduces the risk of antibiotic resistance. Incomplete courses of antibiotics can lead to treatment failure and the development of resistant bacterial strains. Therefore, it is essential for patients to adhere to the prescribed treatment regimen to achieve optimal outcomes.

4. A patient with bipolar disorder is prescribed lithium. What dietary advice should the nurse provide?

• A. Increase intake of caffeine.
• B. Maintain a consistent salt intake.
• C. Avoid dairy products.
• D. Increase intake of green leafy vegetables.

Correct answer: B

Rationale: The correct answer is B: Maintain a consistent salt intake. Patients prescribed lithium should maintain a consistent salt intake to help stabilize lithium levels. Fluctuations in salt intake can affect the levels of lithium in the body, potentially leading to toxicity or reduced effectiveness of the medication. It is important for patients to be consistent with their salt intake and to avoid sudden increases or decreases. Choices A, C, and D are incorrect. Increasing intake of caffeine is not recommended as it can interfere with the effects of lithium. Avoiding dairy products is not necessary unless there are specific intolerances or interactions with other medications. While green leafy vegetables are generally healthy, there is no specific recommendation to increase their intake in relation to lithium therapy.

5. A 9-year-old female client was recently diagnosed with diabetes mellitus. Which symptom will her parents most likely report?

• A. Refuses to eat her favorite meals at home.
• B. Drinks more soft drinks than previously.
• C. Voids only one or two times per day.
• D. Gained 10 pounds within one month.

Correct answer: B

Rationale: The correct answer is B. Increased thirst and fluid intake, such as drinking more soft drinks than previously, is a common symptom of diabetes mellitus in children. This increased thirst is due to the body trying to eliminate excess sugar through urination, leading to dehydration and the need for more fluids. The other choices are less likely to be directly related to the diagnosis of diabetes mellitus in this scenario.

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