Nursing Elites

1. A client with hypoparathyroidism is at risk for which of the following complications?

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

Correct answer: B

Rationale: Hypoparathyroidism is characterized by decreased levels of parathyroid hormone, leading to reduced calcium levels in the blood, which results in hypocalcemia. Therefore, the correct answer is B. Choices A, C, and D are incorrect because hypoparathyroidism does not typically lead to hypercalcemia, hyperkalemia, or hypernatremia. Hypercalcemia is more commonly associated with hyperparathyroidism, where there is excess secretion of parathyroid hormone.

2. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?

• A. Be sure to take glipizide 30 minutes before meals.
• B. Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.
• C. You won't need to check your blood glucose level after you start taking glipizide.
• D. Take glipizide after a meal to prevent heartburn.

Correct answer: A

Rationale: Glipizide should be taken 30 minutes before meals to maximize its glucose-lowering effect.

3. For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?

• A. They contain exudate and provide a moist wound environment.
• B. They protect the wound from mechanical trauma and promote healing.
• C. They debride the wound and promote healing by secondary intention.
• D. They prevent the entrance of microorganisms and minimize wound discomfort.

Correct answer: C

Rationale: Wet-to-dry dressings are utilized in this case to debride the wound by removing dead tissue and promoting healing by secondary intention. Choice A is incorrect as wet-to-dry dressings do not provide a moist wound environment; instead, they promote drying to aid in debridement. Choice B is incorrect because their primary purpose is not to protect the wound but to remove dead tissue. Choice D is incorrect as the main function of wet-to-dry dressings is not to prevent the entrance of microorganisms or minimize wound discomfort.

4. Skillful communication is one behavior of an effective leader. Which of the following describes an effective method of communication?

• A. A unit manager meets with a new nurse to discuss what is going well and what improvements the new nurse can make.
• B. A unit manager meets with a new nurse to explain departmental policy.
• C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent further safety events.
• D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.

Correct answer: A

Rationale: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.

5. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

• A. Elevated blood glucose level and a low plasma bicarbonate
• B. Decreased urine output
• C. Increased respirations and an increase in pH
• D. Comatose state

Correct answer: A

Rationale: The correct answer is A: Elevated blood glucose level and a low plasma bicarbonate. Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketosis, and metabolic acidosis, reflected by a low plasma bicarbonate. Elevated blood glucose levels are a hallmark of DKA due to the body's inability to use glucose properly. Choices B, C, and D are incorrect. Decreased urine output is not a specific finding associated with DKA. Increased respirations and an increase in pH are not typical in DKA; in fact, respiratory compensation for the metabolic acidosis in DKA leads to Kussmaul breathing (deep, rapid breathing). A comatose state may occur in severe cases of DKA but is not a confirming finding for the diagnosis.

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