Nursing Elites

1. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.

2. Which of the following actions could be considered a breach of patient confidentiality?

• A. Discussing patient information with other healthcare providers in a private setting.
• B. Sharing patient information with family members without the patient's consent.
• C. Discussing patient information in public areas where others may overhear.
• D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.

Correct answer: C

Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.

3. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which of the following complications?

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: B

Rationale: The correct answer is B: Hyponatremia. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention in the body. This causes dilutional hyponatremia, where the sodium levels in the blood become abnormally low. Option A, Hypernatremia, is incorrect because SIADH does not cause elevated sodium levels. Option C, Hyperkalemia, is incorrect as SIADH does not directly affect potassium levels. Option D, Hypercalcemia, is also incorrect as SIADH does not impact calcium levels.

4. As a nurse manager rounds on the unit, he speaks with staff, patients, and family members. Later in the day, he is in a meeting with administration. During the conversations, he considers how these interactions impact the care provided to patients on the unit. Which of the following interpersonal activities best describes this manager's actions?

• A. Networking
• B. Employee development
• C. Coaching
• D. Monitoring

Correct answer: A

Rationale: The correct answer is 'Networking.' Networking involves interacting with others to exchange information and develop professional or social contacts. In this scenario, the nurse manager engages in networking by speaking with staff, patients, family members, and administration to understand their perspectives and build relationships. This activity helps the manager gather insights that can positively impact patient care. Choice B, 'Employee development,' focuses on activities aimed at improving staff skills and performance, which is not the primary focus of the manager's actions described. Choice C, 'Coaching,' involves providing guidance and support to individuals to help them achieve specific goals, which is not explicitly depicted in the scenario. Choice D, 'Monitoring,' typically involves overseeing or supervising activities to ensure compliance with standards or objectives, which does not fully capture the manager's proactive engagement in building relationships and gathering information through interactions.

5. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

• A. Obtaining a controlled IV infusion pump
• B. Monitoring urine output during administration
• C. Diluting an appropriate amount of normal saline
• D. Preparing the medication for bolus administration

Correct answer: D

Rationale: The correct answer is preparing the medication for bolus administration (Choice D). Potassium should never be administered as a bolus because it can cause cardiac arrest. It must always be diluted and given slowly. Obtaining a controlled IV infusion pump (Choice A) is essential for accurate delivery, monitoring urine output during administration (Choice B) helps assess the client's response, and diluting an appropriate amount of normal saline (Choice C) is necessary to prevent irritation and ensure safe administration.

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