Nursing Elites

1. 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.

2. 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 building relationships and connecting with staff, patients, and family members to establish a supportive network. In this scenario, the nurse manager is engaging in networking by interacting with various individuals to understand how these interactions influence patient care. 'Employee development' involves activities aimed at enhancing employees' skills and knowledge. 'Coaching' focuses on guiding individuals to improve performance, while 'Monitoring' involves overseeing and supervising activities to ensure compliance and quality.

3. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.

4. The client with type 2 DM is learning to manage blood glucose levels. When should the client monitor blood glucose?

• A. Only when feeling unwell.
• B. Only before meals.
• C. Before meals and at bedtime.
• D. Only after meals.

Correct answer: C

Rationale: The correct answer is to monitor blood glucose before meals and at bedtime. This timing allows the client to assess fasting levels and make informed decisions about mealtime insulin or medication doses. Monitoring only when feeling unwell (choice A) is not sufficient for proper glucose management as it may miss important trends. Monitoring only before meals (choice B) is helpful but does not provide a complete picture of the client's glucose control throughout the day. Monitoring only after meals (choice D) is less beneficial than monitoring before meals as it does not capture fasting levels. Therefore, monitoring before meals and at bedtime (choice C) is the most comprehensive approach to maintain good glucose control and prevent complications.

5. A client is diagnosed with hyperthyroidism. The nurse anticipates which of the following medications to be ordered?

• A. Levothyroxine
• B. Propylthiouracil
• C. Lithium
• D. Metoprolol

Correct answer: B

Rationale: The correct answer is B: Propylthiouracil. Propylthiouracil is an antithyroid medication used to manage hyperthyroidism by inhibiting the synthesis of thyroid hormones. Levothyroxine (Choice A) is typically used to treat hypothyroidism, the opposite of hyperthyroidism. Lithium (Choice C) is not used to treat hyperthyroidism but is commonly used to manage bipolar disorder. Metoprolol (Choice D) is a beta-blocker that may be used to manage symptoms like tachycardia associated with hyperthyroidism, but it is not the primary treatment for the condition.

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