Nursing Elites

1. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?

• A. Decreased heart rate
• B. Increased weight
• C. Increased energy levels
• D. Decreased appetite

Correct answer: C

Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.

2. A client with diabetes mellitus visits a health care clinic. The client's diabetes was previously well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone (Deltasone)
• B. Atenolol (Tenormin)
• C. Phenelzine (Nardil)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone, a corticosteroid, can increase blood glucose levels by promoting gluconeogenesis and decreasing glucose uptake by cells. This medication can lead to hyperglycemia in patients, especially those with diabetes mellitus. Atenolol (Tenormin) is a beta-blocker and is not known to significantly affect blood glucose levels. Phenelzine (Nardil) is a monoamine oxidase inhibitor used to treat depression and anxiety disorders; it does not typically impact blood glucose levels. Allopurinol (Zyloprim) is a xanthine oxidase inhibitor used to manage gout and does not interfere with blood glucose regulation.

3. Which advice is most beneficial for a new nurse manager?

• A. Strive to embody the manager your staff desires while also aligning with your administration's expectations.
• B. Keep in mind that it may take 6 months to feel at ease in a new role.
• C. Begin by mentoring other novice nurse managers.
• D. Participate in substantial personal growth endeavors.

Correct answer: B

Rationale: The most helpful advice for a new nurse manager is to understand that it can take up to 6 months to feel comfortable in a new position. This allows the individual to manage their expectations and give themselves time to adapt to their new role. Choice A may be overwhelming and could cause conflicting priorities for the new nurse manager. Choice C, while valuable, might not be the immediate focus for someone new to the role. Choice D, although important, may not be as time-sensitive as the adjustment period in the new position.

4. Which of the following is an example of nonmaleficence in nursing practice?

• A. Administering pain medication as prescribed to prevent patient discomfort.
• B. Ensuring that a patient does not receive a treatment that they have refused.
• C. Ensuring that a patient receives appropriate care without causing harm.
• D. Encouraging a patient to express their concerns and fears about a procedure.

Correct answer: B

Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.

5. The client with hyperparathyroidism is being taught about dietary management. Which of the following foods should the client avoid?

• A. Bananas
• B. Spinach
• C. Milk
• D. Processed meats

Correct answer: C

Rationale: Clients with hyperparathyroidism should avoid high-calcium foods like milk because they already have elevated calcium levels. Bananas and spinach are not high in calcium and can be included in the diet. Processed meats are not specifically contraindicated in hyperparathyroidism, so they are not the correct answer.

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