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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 with chronic obstructive pulmonary disease (COPD) is receiving prednisone (Deltasone). Which side effect should the nurse monitor for?
- A. Hypoglycemia
- B. Infection
- C. Hypotension
- D. Weight loss
Correct answer: B
Rationale: The correct answer is B: Infection. Prednisone is an immunosuppressant medication commonly used in COPD to reduce inflammation. Due to its immunosuppressive effects, clients are at an increased risk of developing infections. Therefore, nurses should closely monitor clients receiving prednisone for signs and symptoms of infections to provide timely interventions.
3. Which assessment finding indicates a client's readiness to leave the nursing unit for a bronchoscopy?
- A. Client denies allergies to contrast media.
- B. Skin prep to insertion site completed.
- C. On-call sedation administered.
- D. Oxygen at 2 L/minute via nasal cannula.
Correct answer: C
Rationale: Administering on-call sedation is crucial before a bronchoscopy to ensure the client is comfortable and adequately prepared for the procedure. Sedation helps reduce anxiety, discomfort, and ensures the client remains still during the bronchoscopy, enabling the healthcare provider to perform the procedure effectively.
4. When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?
- A. The nurse is indicating disapproval of the statement.
- B. The nurse is showing respect for the client's loss.
- C. Silence is mirroring the client's sadness.
- D. Silence enables the client to contemplate what was expressed.
Correct answer: D
Rationale: In therapeutic communication, silence can offer the client an opportunity to process their emotions and thoughts. By remaining silent, the nurse provides a space for the client to reflect on their own words, facilitating deeper exploration and understanding of their feelings.
5. A patient with hyperlipidemia is prescribed atorvastatin. What lab test should be monitored periodically to assess for adverse effects?
- A. Liver function tests
- B. Complete blood count
- C. Blood glucose levels
- D. Serum potassium
Correct answer: A
Rationale: The correct answer is A: Liver function tests. Patients on atorvastatin should have their liver function tests monitored periodically to detect any potential liver damage. Atorvastatin, a statin medication used to lower cholesterol levels, can rarely cause liver enzyme abnormalities, so regular monitoring is essential to identify any adverse effects early on. Monitoring the complete blood count (choice B), blood glucose levels (choice C), or serum potassium (choice D) is not typically required specifically for atorvastatin therapy. While these tests may be important for other conditions or medications, liver function tests are the most relevant for monitoring the adverse effects of atorvastatin.
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