Nursing Elites

1. A client with type 1 DM is experiencing signs of hypoglycemia. The nurse should expect which of the following symptoms?

• A. Tachycardia
• B. Polyuria
• C. Flushed skin
• D. Dry mouth

Correct answer: A

Rationale: In a client experiencing hypoglycemia, tachycardia is a common symptom. This occurs due to the release of adrenaline in response to low blood glucose levels, which stimulates the heart to beat faster. Polyuria, the increased production of urine, flushed skin, and dry mouth are not typical symptoms of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes insipidus or uncontrolled diabetes mellitus. Flushed skin and dry mouth are not direct physiological responses to low blood sugar levels.

2. The client with DM is being taught about foot care. The nurse instructs the client to:

• A. Avoid hot water when bathing the feet.
• B. Apply a moisturizing lotion to the feet, especially between the toes.
• C. Use a heating pad to warm the feet if they feel cold.
• D. Go barefoot at home to allow the feet to air out.

Correct answer: A

Rationale: The correct answer is to avoid hot water when bathing the feet. This instruction is crucial because clients with diabetes may have decreased sensation in their feet, which can put them at risk of burns from hot water. Choice B is incorrect because applying moisturizing lotion between the toes can increase moisture and promote fungal growth. Choice C is incorrect because using a heating pad can also lead to burns due to decreased sensation. Choice D is incorrect as going barefoot can increase the risk of injury and infections in clients with diabetes.

3. The healthcare provider is assessing a client with hypothyroidism. Which of the following clinical findings would the healthcare provider expect?

• A. Tachycardia
• B. Weight loss
• C. Cold intolerance
• D. Diaphoresis

Correct answer: C

Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a reduced ability to regulate body temperature. As a result, individuals with hypothyroidism often feel cold, especially in their extremities. Tachycardia (A) is more commonly associated with hyperthyroidism due to the increased metabolic rate. Weight loss (B) is also a typical finding in hyperthyroidism, as the body burns calories at a faster rate. Diaphoresis (D), excessive sweating, is not a typical symptom of hypothyroidism.

4. Which of the following is a primary goal of nursing?

• A. Assist patients in achieving a peaceful death.
• B. Enhance personal knowledge and skills to improve patient outcomes.
• C. Champion quality of life over quantity of life.
• D. Manage costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to assist patients in achieving a peaceful death if recovery is not feasible. This involves providing comfort, dignity, and support during the end-of-life process. Choice B is incorrect because while improving personal knowledge and skills is important, it is not the primary goal of nursing. Choice C, advocating for quality of life over quantity of life, is a valid aspect of nursing care but may not always be the primary goal. Choice D, managing costs to enhance patients' quality of life, is not a primary goal of nursing, as the focus should primarily be on patient care and well-being, rather than financial considerations.

5. 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.

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