Nursing Elites

1. A client with Cushing's syndrome has been prescribed a diet low in sodium. The nurse knows that the client should avoid which of the following foods?

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

Correct answer: C

Rationale: The correct answer is C: Processed meats. Clients with Cushing's syndrome who are on a low-sodium diet should avoid processed meats because they are typically high in sodium. Bananas, spinach, and oatmeal are generally low in sodium and can be included in a low-sodium diet. Bananas are a good source of potassium, spinach is rich in vitamins and minerals, and oatmeal is a healthy whole grain option. Therefore, choices A, B, and D are not the best options to avoid for a client with Cushing's syndrome following a low-sodium diet.

2. 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.

3. When caring for a female client with a history of hypoglycemia, Nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?

• A. Sulfisoxazole (Gantrisin)
• B. Mexiletine (Mexitil)
• C. Prednisone (Orasone)
• D. Lithium carbonate (Lithobid)

Correct answer: A

Rationale: The correct answer is A, Sulfisoxazole (Gantrisin). Sulfisoxazole is known to potentiate hypoglycemia, making it unsafe for clients with a history of hypoglycemia. Choice B, Mexiletine, is a medication used to treat certain heart rhythm problems and is not associated with hypoglycemia. Choice C, Prednisone, is a corticosteroid and does not potentiate hypoglycemia. Choice D, Lithium carbonate, is commonly used to treat bipolar disorder and does not typically potentiate hypoglycemia. Therefore, the drug that Nurse Ruby should avoid in this case is Sulfisoxazole (Gantrisin) to prevent worsening the client's hypoglycemic condition.

4. A male client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder?

• A. Serum potassium level
• B. Serum sodium level
• C. Arterial blood gas (ABG) values
• D. Serum osmolarity

Correct answer: D

Rationale: Serum osmolarity is the most important laboratory test for confirming hyperosmolar hyperglycemic nonketotic syndrome (HHNS). HHNS is characterized by severe hyperglycemia and dehydration without ketoacidosis. Elevated serum osmolarity indicates increased solute concentration in the blood, which is a hallmark of HHNS. Serum potassium level (Choice A) is important in conditions like diabetic ketoacidosis rather than HHNS. Serum sodium level (Choice B) may be affected in HHNS but is not the primary test for confirming the disorder. Arterial blood gas (ABG) values (Choice C) are more useful in assessing acid-base status, which is not the primary concern in HHNS.

5. The client with DM is being taught by the nurse about the importance of monitoring blood glucose levels. The nurse should instruct the client to:

• A. Check blood glucose only when feeling unwell.
• B. Check blood glucose before meals and at bedtime.
• C. Check blood glucose only after meals.
• D. Check blood glucose only in the morning.

Correct answer: B

Rationale: The correct answer is to check blood glucose before meals and at bedtime. Monitoring blood glucose levels before meals allows the client to adjust their insulin or oral antidiabetic medications based on their current levels. Checking at bedtime helps in ensuring blood glucose levels are at a safe range throughout the night. Option A is incorrect because blood glucose should be monitored regularly as part of diabetes management, not just when feeling unwell. Option C is incorrect because checking only after meals does not provide a complete picture of blood glucose control throughout the day. Option D is incorrect as checking only in the morning does not cover the full spectrum of blood glucose variations that can occur during the day.

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