Nursing Elites

1. In a male client with a history of hypertension diagnosed with primary hyperaldosteronism, the hypertension is caused by excessive hormone secretion from which of the following glands?

• A. Adrenal cortex
• B. Pancreas
• C. Adrenal medulla
• D. Parathyroid

Correct answer: A

Rationale: Primary hyperaldosteronism is characterized by excessive secretion of aldosterone from the adrenal cortex. Aldosterone, a hormone produced by the adrenal cortex, plays a crucial role in regulating blood pressure by promoting sodium and water retention in the kidneys. The adrenal medulla secretes catecholamines like epinephrine and norepinephrine, which are involved in the 'fight or flight' response, not in regulating blood pressure. The pancreas secretes insulin and glucagon, hormones involved in blood sugar regulation, not blood pressure. The parathyroid glands regulate calcium levels in the blood, not blood pressure.

2. A client with type 1 DM is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should prioritize which action?

• A. Administering intravenous fluids.
• B. Administering oral glucose.
• C. Administering a fever-reducing medication.
• D. Administering oxygen therapy.

Correct answer: A

Rationale: Administering intravenous fluids is the priority in treating DKA for several reasons. DKA is characterized by severe dehydration and electrolyte imbalances due to hyperglycemia. IV fluids help to correct dehydration, restore electrolyte balance, and decrease blood glucose levels. Administering oral glucose (Choice B) would be contraindicated in DKA as the primary issue is high blood glucose levels. Administering a fever-reducing medication (Choice C) is not the priority in managing DKA. Administering oxygen therapy (Choice D) may be necessary in some cases, but correcting dehydration and electrolyte imbalances take precedence in the management of DKA.

3. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

• A. Fluid intake is less than 2,500 ml/day
• B. Urine output measures more than 200 ml/hour
• C. Blood pressure is 90/50 mm Hg
• D. The heart rate is 126 beats/minute

Correct answer: A

Rationale: The correct outcome indicating effective treatment of diabetes insipidus in a male client is a fluid intake of less than 2,500 ml/day. In diabetes insipidus, excessive urination causes increased fluid intake to compensate for the fluid loss. By effectively managing the condition, the client's fluid intake should decrease. Choices B, C, and D do not directly reflect the effectiveness of treatment for diabetes insipidus. Increased urine output (choice B) may indicate inadequate control of the condition, while low blood pressure (choice C) and a high heart rate (choice D) are not specific indicators of effective treatment for diabetes insipidus.

4. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?

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

Correct answer: B

Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.

5. Which of the following best describes the way for a follower to 'manage up'?

• A. Provide feedback to the unit manager when requested.
• B. Assist the manager in capitalizing on their strengths and weaknesses.
• C. If a follower works with a manager displaying poor leadership skills, they should transfer to a different unit.
• D. Demonstrate respect and appreciation for the manager, even when conversing with coworkers.

Correct answer: B

Rationale: The best way for a follower to 'manage up' is to assist the manager in capitalizing on their strengths and weaknesses. This approach involves supporting the manager in leveraging their strengths while helping them address and improve upon their weaknesses. Choice A is not specific enough about the context of providing feedback, which may not always be the best way to manage up. Choice C suggests avoiding the situation rather than actively managing it. Choice D, while important, does not directly address the concept of managing up by helping the manager grow and excel.

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