Nursing Elites

1. A client with type 1 diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which of the following interventions should be the nurse's priority?

• A. Administer intravenous insulin
• B. Start an intravenous line and infuse normal saline
• C. Monitor serum potassium levels
• D. Obtain an arterial blood gas (ABG)

Correct answer: B

Rationale: The correct answer is to start an intravenous line and infuse normal saline. In diabetic ketoacidosis (DKA), the priority intervention is fluid resuscitation with normal saline to restore intravascular volume and improve perfusion. Administering insulin without first addressing dehydration and electrolyte imbalances can lead to further complications. Monitoring serum potassium levels and obtaining an arterial blood gas (ABG) are important aspects of DKA management but come after initial fluid resuscitation.

2. The client has hyperparathyroidism. Which of the following dietary instructions should the nurse provide?

• A. Increase calcium intake
• B. Limit phosphorus intake
• C. Increase fluid intake
• D. Limit vitamin D intake

Correct answer: C

Rationale: The correct answer is to 'Increase fluid intake.' This is because increasing fluid intake helps prevent kidney stones, a common complication of hyperparathyroidism. While calcium is involved in the condition, increasing calcium intake is not recommended as it can exacerbate hypercalcemia, which is commonly present in hyperparathyroidism. Limiting phosphorus intake is not directly related to managing hyperparathyroidism. Limiting vitamin D intake is also not typically necessary in managing hyperparathyroidism, as it is usually a calcium and PTH-related issue.

3. A nurse manager is reviewing the nurse’s documentation on the unit. Which of the following best describes the importance of this review?

• A. The nurse manager’s review of documentation is crucial to ensure that it meets legal and ethical standards and accurately reflects the care provided to patients.
• B. The nurse manager’s review of documentation is important to ensure that it is thorough, accurate, and reflects the nurse’s accountability for patient care.
• C. The nurse manager’s review of documentation is necessary to ensure that it is consistent with the unit’s policies and procedures and that it accurately reflects the care provided.
• D. The nurse manager’s review of documentation is essential to ensure that it meets regulatory requirements and that it supports the delivery of safe and effective patient care.

Correct answer: D

Rationale: The nurse manager's review of documentation is a critical aspect of maintaining quality patient care. Choice D is the correct answer as it highlights the importance of ensuring that documentation meets regulatory requirements, supporting the delivery of safe and effective patient care. Regulatory requirements are established to ensure that healthcare facilities function within established guidelines and standards, promoting patient safety and quality of care. Choices A, B, and C, although important aspects of documentation review, do not fully encapsulate the significant role of regulatory compliance in ensuring the overall quality and safety of patient care.

4. A healthcare professional is reviewing the medication orders for a client with hypothyroidism. Which of the following medications should the healthcare professional question?

• A. Levothyroxine
• B. Amiodarone
• C. Calcium supplements
• D. Aspirin

Correct answer: B

Rationale: The correct answer is B: Amiodarone. Amiodarone can affect thyroid function and potentially worsen hypothyroidism, so its use should be carefully considered or questioned in clients with this condition. Levothyroxine (Choice A) is the mainstay therapy for hypothyroidism and should not be questioned in this scenario. Calcium supplements (Choice C) are not typically contraindicated in clients with hypothyroidism and may be needed if there is a deficiency. Aspirin (Choice D) is not directly related to thyroid function and is not a medication that would typically be questioned in a client with hypothyroidism.

5. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

• A. Antidiuretic hormone (ADH)
• B. Thyroid-stimulating hormone (TSH)
• C. Follicle-stimulating hormone (FSH)
• D. Luteinizing hormone (LH)

Correct answer: A

Rationale: Diabetes insipidus is a condition characterized by a deficiency of antidiuretic hormone (ADH). ADH plays a crucial role in regulating water balance by controlling the amount of water reabsorbed by the kidneys. Options B, C, and D are incorrect as they are not associated with diabetes insipidus. TSH (thyroid-stimulating hormone) is responsible for regulating thyroid function, while FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are involved in reproductive functions.

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