Nursing Elites

1. A client with hyperthyroidism is prescribed propranolol. The nurse explains that this medication is used to:

• A. Increase thyroid hormone production
• B. Decrease thyroid hormone production
• C. Relieve symptoms such as tachycardia and anxiety
• D. Prevent weight loss

Correct answer: C

Rationale: Propranolol is a beta-blocker that works by blocking the effects of adrenaline, which helps to reduce symptoms such as tachycardia (fast heart rate) and anxiety in individuals with hyperthyroidism. Choices A and B are incorrect because propranolol does not affect thyroid hormone production; it only addresses symptoms. Choice D is incorrect because propranolol does not prevent weight loss associated with hyperthyroidism.

2. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?

• A. Weight gain
• B. Hypoglycemia
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.

3. The healthcare provider is monitoring a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the healthcare provider include in the care plan?

• A. Encourage oral fluids
• B. Restrict fluid intake
• C. Administer potassium supplements
• D. Increase sodium intake

Correct answer: B

Rationale: The correct intervention for a client with SIADH is to restrict fluid intake. SIADH leads to water retention and dilution of sodium levels in the body, resulting in hyponatremia. Restricting fluid intake helps prevent further dilutional hyponatremia. Encouraging oral fluids (Choice A) would exacerbate the condition by further increasing fluid retention. Administering potassium supplements (Choice C) is not directly related to managing SIADH. Increasing sodium intake (Choice D) is contraindicated because it can worsen hyponatremia in clients with SIADH.

4. The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?

• A. Increase intake of dairy products and green leafy vegetables
• B. Avoid foods high in calcium
• C. Consume a high-sodium diet
• D. Limit fluid intake to prevent fluid overload

Correct answer: A

Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.

5. A nurse manager is reviewing data from the unit. More than 50% of new nurses hired left within 1 year of being hired. Which of the following implementations should the nurse manager consider to improve retention of newly hired nurses?

• A. Increase the length of time new hires spend in training.
• B. Conduct a performance review at 3, 6, and 9 months to review the new nurse’s weaknesses.
• C. Stress the importance of continuity of care to new hires.
• D. Build the manager’s own leadership skills through building relationships with staff members.

Correct answer: D

Rationale: To improve retention of newly hired nurses, the nurse manager should focus on building their own leadership skills and relationships with staff members. By creating a supportive environment and demonstrating effective leadership, the manager can positively impact staff retention. Options A, B, and C do not directly address the core issue of creating a supportive work environment and effective leadership, which are crucial for retaining newly hired nurses.

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