Nursing Elites

1. A client with diabetes mellitus visits a health care clinic. The client's diabetes was previously well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone (Deltasone)
• B. Atenolol (Tenormin)
• C. Phenelzine (Nardil)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone, a corticosteroid, can increase blood glucose levels by promoting gluconeogenesis and decreasing glucose uptake by cells. This medication can lead to hyperglycemia in patients, especially those with diabetes mellitus. Atenolol (Tenormin) is a beta-blocker and is not known to significantly affect blood glucose levels. Phenelzine (Nardil) is a monoamine oxidase inhibitor used to treat depression and anxiety disorders; it does not typically impact blood glucose levels. Allopurinol (Zyloprim) is a xanthine oxidase inhibitor used to manage gout and does not interfere with blood glucose regulation.

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. Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:

• A. Hypotension.
• B. Thick, coarse skin.
• C. Deposits of adipose tissue in the trunk and dorsocervical area.
• D. Weight gain in arms and legs.

Correct answer: C

Rationale: In Cushing's syndrome, the characteristic features include central obesity with deposits of adipose tissue in the trunk and dorsocervical area, often referred to as a 'buffalo hump.' Hypotension (Choice A) is not typically associated with Cushing's syndrome; instead, hypertension is more common. Thick, coarse skin (Choice B) is seen in conditions like hypothyroidism, not specifically in Cushing's syndrome. Weight gain in the arms and legs (Choice D) is not a typical finding in Cushing's syndrome; rather, weight gain is more prominent in the central areas of the body.

4. The nurse is caring for a client with hyperaldosteronism. Which of the following laboratory results would the nurse expect?

• A. Hypokalemia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: In hyperaldosteronism, there is an excess of aldosterone production, leading to increased sodium retention and potassium excretion by the kidneys. This results in hypokalemia (low potassium levels). Therefore, the correct answer is hypokalemia (Choice A). Hypernatremia (Choice B) is an incorrect choice as hyperaldosteronism primarily affects potassium and not sodium levels. Hyperkalemia (Choice C) is also incorrect because hyperaldosteronism causes potassium excretion, leading to low levels. Hypocalcemia (Choice D) is not typically associated with hyperaldosteronism; instead, it is more related to conditions affecting calcium regulation.

5. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?

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

Correct answer: B

Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.

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