Nursing Elites

1. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should Nurse Hans recognize as an adverse drug effect?

• A. Dysuria
• B. Leg cramps
• C. Tachycardia
• D. Blurred vision

Correct answer: C

Rationale: Tachycardia is a potential adverse effect of levothyroxine, indicating overmedication. Dysuria (painful urination) is not typically associated with levothyroxine. Leg cramps are not a common adverse effect of levothyroxine. Blurred vision is not a typical adverse effect of levothyroxine; instead, it may be a sign of other eye-related conditions or medication side effects.

2. Which of the following laboratory values should the nurse monitor in a client with Cushing's syndrome?

• A. Blood glucose levels
• B. Serum calcium levels
• C. Serum potassium levels
• D. Serum sodium levels

Correct answer: A

Rationale: The correct answer is A: Blood glucose levels. In Cushing's syndrome, there is excess cortisol in the body which leads to increased blood glucose levels due to its effect on glucose metabolism. Elevated blood glucose levels are a common finding in individuals with Cushing's syndrome. Monitoring blood glucose levels is crucial as it helps in assessing and managing hyperglycemia in these patients. Choice B, serum calcium levels, is not typically a priority in monitoring for Cushing's syndrome. While abnormalities in calcium levels can occur in some endocrine disorders, hypercalcemia is not a hallmark of Cushing's syndrome. Choice C, serum potassium levels, and Choice D, serum sodium levels, are not directly associated with Cushing's syndrome. While electrolyte imbalances can occur in various conditions, they are not specifically linked to Cushing's syndrome as blood glucose levels are.

3. 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.

4. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?

• A. Vasopressin (Pitressin Synthetic)
• B. Furosemide (Lasix)
• C. Regular insulin
• D. 10% dextrose

Correct answer: A

Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.

5. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager’s actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.

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