Nursing Elites

1. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. The nurse should instruct the client to do which of the following?

• A. Eat a high-protein snack
• B. Consume 15 grams of simple carbohydrates
• C. Drink a glass of water
• D. Administer an extra dose of insulin

Correct answer: B

Rationale: Consuming 15 grams of simple carbohydrates is the recommended treatment for mild hypoglycemia to quickly raise blood sugar levels. Simple carbohydrates are rapidly absorbed and provide a quick source of glucose to combat low blood sugar. Eating a high-protein snack (Choice A) would delay the rise in blood sugar as proteins take longer to be broken down. Drinking water (Choice C) does not directly address the low blood sugar levels associated with hypoglycemia. Administering an extra dose of insulin (Choice D) would further lower blood sugar levels, worsening the hypoglycemic state.

2. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?

• A. Serum calcium.
• B. Serum phosphorus.
• C. Serum potassium.
• D. Serum sodium.

Correct answer: C

Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.

3. The nurse is caring for a client with hyperparathyroidism. Which of the following clinical manifestations is consistent with this condition?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperphosphatemia

Correct answer: B

Rationale: In hyperparathyroidism, there is an overproduction of parathyroid hormone, leading to increased calcium levels in the blood (hypercalcemia). This occurs as the parathyroid hormone stimulates the release of calcium from the bones and enhances calcium absorption in the intestines and kidneys. Therefore, the correct answer is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not consistent with hyperparathyroidism, as this condition is characterized by high calcium levels. Hypokalemia (Choice C) and hyperphosphatemia (Choice D) are not typically associated with hyperparathyroidism and are not primary manifestations of this condition.

4. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?

• A. Tap water
• B. Sterile water
• C. Sodium chloride
• D. Normal saline

Correct answer: C

Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.

5. A client with Cushing's syndrome is being assessed by the nurse. Which of the following clinical manifestations is consistent with this condition?

• A. Moon face
• B. Weight loss
• C. Hyperpigmentation
• D. Hypotension

Correct answer: A

Rationale: The correct clinical manifestation consistent with Cushing's syndrome is a 'moon face.' Cushing's syndrome is characterized by fat redistribution, leading to the round and full appearance of the face known as a moon face. Choice B, weight loss, is not common in Cushing's syndrome as patients often experience weight gain. Choice C, hyperpigmentation, is more indicative of Addison's disease, not Cushing's syndrome. Choice D, hypotension, is not typically associated with Cushing's syndrome which often presents with hypertension due to excess cortisol.

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