Nursing Elites

1. A client with diabetes insipidus is receiving desmopressin therapy. The nurse should monitor for which of the following potential side effects?

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

Correct answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used to treat diabetes insipidus, can cause the retention of water without sodium, leading to dilutional hyponatremia. This occurs because desmopressin increases water reabsorption in the kidneys without affecting sodium levels. Hypernatremia (choice B) is unlikely because desmopressin does not cause excessive sodium retention. Hypokalemia (choice C) and hypercalcemia (choice D) are not typically associated with desmopressin therapy for diabetes insipidus.

2. The client with newly diagnosed diabetes mellitus is being taught about managing blood glucose levels. Which statement indicates a need for further teaching?

• A. I will rotate my insulin injection sites to avoid tissue damage.
• B. I will monitor my blood glucose levels before each meal.
• C. I can eat unlimited fruit as it is healthy.
• D. I should carry a fast-acting carbohydrate with me at all times.

Correct answer: C

Rationale: Choice C indicates a need for further teaching because stating 'I can eat unlimited fruit as it is healthy' is incorrect. While fruits are healthy, they also contain natural sugars that can affect blood glucose levels. Portion control is crucial to managing blood glucose levels effectively. Choices A, B, and D demonstrate correct understanding. Rotating insulin injection sites helps prevent tissue damage, monitoring blood glucose levels before meals aids in managing diabetes effectively, and carrying a fast-acting carbohydrate is essential to treat hypoglycemia promptly.

3. A client with DM is experiencing symptoms of hypoglycemia. Which action should the nurse take first?

• A. Give the client a glass of orange juice.
• B. Administer insulin as ordered.
• C. Check the client's blood glucose level.
• D. Notify the healthcare provider.

Correct answer: C

Rationale: The correct first action when a client with DM is experiencing symptoms of hypoglycemia is to check the client's blood glucose level. This step is crucial to confirm hypoglycemia before initiating any treatment. Giving the client orange juice (Choice A) is a common intervention for treating hypoglycemia, but it should not be done before confirming the blood glucose level. Administering insulin (Choice B) is not appropriate for hypoglycemia as it would further decrease the blood glucose levels. Notifying the healthcare provider (Choice D) can be important, but the immediate priority is to assess the blood glucose level to guide treatment.

4. A client with hypothyroidism is at risk for which of the following complications?

• A. Thyroid storm
• B. Myxedema coma
• C. Cushing's syndrome
• D. Diabetic ketoacidosis

Correct answer: B

Rationale: Myxedema coma is a severe, life-threatening complication that can occur in individuals with untreated or inadequately treated hypothyroidism. It is characterized by extreme hypothyroidism leading to decreased mental status, hypothermia, bradycardia, and respiratory depression. Thyroid storm (Choice A) is a severe complication of hyperthyroidism, not hypothyroidism. Cushing's syndrome (Choice C) results from prolonged exposure to high levels of cortisol, not related to hypothyroidism. Diabetic ketoacidosis (Choice D) is a complication of uncontrolled diabetes, not directly associated with hypothyroidism.

5. The healthcare provider is assessing a client with Addison's disease. Which of the following symptoms is consistent with this condition?

• A. Hypertension
• B. Hyperglycemia
• C. Hyperpigmentation
• D. Weight gain

Correct answer: C

Rationale: Hyperpigmentation is a characteristic symptom of Addison's disease. In Addison's disease, there is a decrease in cortisol production, leading to an increase in adrenocorticotropic hormone (ACTH) secretion by the pituitary gland. Excess ACTH can stimulate melanocytes, resulting in hyperpigmentation. Choices A, B, and D are not typically associated with Addison's disease. Hypertension is more commonly associated with conditions involving excess cortisol production, such as Cushing's syndrome. Hyperglycemia may occur in diabetes mellitus but is not a hallmark of Addison's disease. Weight loss, rather than weight gain, is a common symptom of Addison's disease due to decreased cortisol levels.

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