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. Which of the following is a priority nursing diagnosis for a client with Addison's disease?

• A. Fluid volume deficit
• B. Risk for infection
• C. Imbalanced nutrition: Less than body requirements
• D. Disturbed body image

Correct answer: A

Rationale: The priority nursing diagnosis for a client with Addison's disease is 'Fluid volume deficit.' Addison's disease is characterized by adrenal insufficiency, resulting in decreased aldosterone production. Aldosterone plays a key role in sodium and water retention in the body. With its deficiency, there is an increased risk of dehydration and electrolyte imbalance, leading to fluid volume deficit. While infection risk, nutrition issues, and body image disturbances are also important considerations for holistic care, addressing the fluid volume deficit takes precedence due to the immediate physiological impact on the client's health and well-being.

3. The client with hypothyroidism is being educated by the healthcare provider about taking levothyroxine. Which of the following instructions should be included?

• A. Take the medication with meals
• B. Take the medication at bedtime
• C. Take the medication on an empty stomach in the morning
• D. Take the medication with a glass of milk

Correct answer: C

Rationale: The correct answer is to take levothyroxine on an empty stomach in the morning. This instruction is essential to enhance absorption and efficacy of the medication. Taking levothyroxine with meals, at bedtime, or with a glass of milk can interfere with its absorption and effectiveness, leading to suboptimal treatment outcomes.

4. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

• A. Increasing saturated fat intake and fasting in the afternoon
• B. Increasing intake of vitamins B and D and taking iron supplements
• C. Eating a candy bar if lightheadedness occurs
• D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting

Correct answer: D

Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.

5. The nurse is caring for a client with hyperaldosteronism. Which of the following laboratory results would the nurse expect?

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

Correct answer: A

Rationale: In hyperaldosteronism, there is an excess of aldosterone production, leading to increased sodium retention and potassium excretion by the kidneys. This results in hypokalemia (low potassium levels). Therefore, the correct answer is hypokalemia (Choice A). Hypernatremia (Choice B) is an incorrect choice as hyperaldosteronism primarily affects potassium and not sodium levels. Hyperkalemia (Choice C) is also incorrect because hyperaldosteronism causes potassium excretion, leading to low levels. Hypocalcemia (Choice D) is not typically associated with hyperaldosteronism; instead, it is more related to conditions affecting calcium regulation.

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