Nursing Elites

1. A client with Addison's disease is experiencing an Addisonian crisis. The nurse should expect to administer which of the following medication?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: During an Addisonian crisis, the adrenal glands are not producing enough cortisol, leading to a life-threatening situation. Hydrocortisone, a glucocorticoid, is the medication of choice in managing an Addisonian crisis. It helps replace deficient cortisol levels, stabilize blood pressure, and prevent further complications. Insulin (Choice A) is not indicated in Addison's disease unless specifically needed for diabetes management. Levothyroxine (Choice C) is used in hypothyroidism, not in Addison's disease. Methimazole (Choice D) is used to manage hyperthyroidism, which is not related to Addison's disease or its crisis.

2. What health concerns should Nurse Oliver expect a client with hypothyroidism to report?

• A. Increased appetite and weight loss
• B. Puffiness of the face and hands
• C. Nervousness and tremors
• D. Thyroid gland swelling

Correct answer: B

Rationale: Puffiness of the face and hands is a classic symptom of hypothyroidism. This occurs due to fluid retention and is commonly observed in individuals with an underactive thyroid gland. Increased appetite and weight loss (Choice A) are more indicative of hyperthyroidism, where there is an overproduction of thyroid hormones leading to increased metabolism. Nervousness and tremors (Choice C) are associated with hyperthyroidism, not hypothyroidism. Thyroid gland swelling (Choice D) typically indicates goiter, which can be present in both hyperthyroidism and hypothyroidism but is not a specific symptom that clients with hypothyroidism commonly report.

3. Which of the following ethical principles involves the fair and equitable distribution of resources?

• A. Justice
• B. Fidelity
• C. Autonomy
• D. Veracity

Correct answer: A

Rationale: The correct answer is A: Justice. Justice is the ethical principle that focuses on the fair and equitable distribution of resources, ensuring that all individuals receive appropriate care based on their needs. Fidelity (B) refers to being faithful or loyal to commitments and obligations. Autonomy (C) relates to respecting an individual's right to make their own decisions. Veracity (D) pertains to truthfulness and honesty in communication with patients.

4. A client with hyperthyroidism is being treated with radioactive iodine. The nurse should teach the client to expect which of the following side effects?

• A. Increased heart rate
• B. Hypothyroidism
• C. Hypercalcemia
• D. Weight loss

Correct answer: B

Rationale: When a client with hyperthyroidism undergoes radioactive iodine treatment, it often leads to hypothyroidism due to the destruction of thyroid tissue. This occurs as a desired outcome of the treatment to reduce the overactive thyroid function. Choices A, C, and D are incorrect. Increased heart rate, hypercalcemia, and weight loss are not expected side effects of radioactive iodine treatment for hyperthyroidism. Instead, the goal is to suppress the overactive thyroid, leading to a hypothyroid state.

5. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?

• A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
• B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
• C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
• D. It regulates the threshold for water reabsorption in the kidneys.

Correct answer: C

Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.

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