Nursing Elites

1. A healthcare professional caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the healthcare professional note in a client with this condition?

• A. Lung congestion
• B. Decreased hematocrit
• C. Increased blood pressure
• D. Decreased central venous pressure (CVP)

Correct answer: D

Rationale: Decreased central venous pressure (CVP) is the correct assessment finding in a client with deficient fluid volume. This is because a decrease in CVP indicates reduced blood volume returning to the heart, which is consistent with hypovolemia. Lung congestion (Choice A) would be more indicative of fluid volume excess, not deficiency. Decreased hematocrit (Choice B) may be seen in conditions such as anemia but is not specific to deficient fluid volume. Increased blood pressure (Choice C) is not typically associated with deficient fluid volume; in fact, hypovolemia often leads to decreased blood pressure.

2. The client with hyperparathyroidism is being taught about dietary management. Which of the following foods should the client avoid?

• A. Bananas
• B. Spinach
• C. Milk
• D. Processed meats

Correct answer: C

Rationale: Clients with hyperparathyroidism should avoid high-calcium foods like milk because they already have elevated calcium levels. Bananas and spinach are not high in calcium and can be included in the diet. Processed meats are not specifically contraindicated in hyperparathyroidism, so they are not the correct answer.

3. A psychological contract exists between staff members and nurse managers. Which of the following best describes this relationship?

• A. Nurse managers provide positive evaluations, and in turn, staff members do what managers ask of them.
• B. Nurse managers coordinate multiple departments and supervise multiple staff members.
• C. Staff members do what managers ask of them and, in turn, are rewarded through assignments, promotions, and evaluations.
• D. Nurse managers advocate for staff and support nursing roles and ethical practice.

Correct answer: C

Rationale: The correct answer is C. In a psychological contract between staff members and nurse managers, staff members are expected to fulfill the requests of managers, and in return, they are rewarded with assignments, promotions, and evaluations. This reciprocal relationship forms the basis of the psychological contract. Choices A, B, and D are incorrect because they do not accurately capture the essence of the psychological contract. While nurse managers may provide positive evaluations, coordinate departments, supervise staff, advocate for staff, and support nursing roles, these actions alone do not define the specific reciprocal nature of the psychological contract outlined in choice C.

4. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.

5. A client with type 2 diabetes mellitus is taking metformin. The nurse should monitor the client for which of the following potential side effects?

• A. Lactic acidosis
• B. Hypokalemia
• C. Hyperglycemia
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or other predisposing factors. Monitoring for signs and symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or irregular heartbeat, is crucial when a client is taking metformin. Choice B, hypokalemia, is not a common side effect of metformin. Choice C, hyperglycemia, is contrary to the intended effect of metformin, which is to lower blood glucose levels. Choice D, weight gain, is not typically associated with metformin use; in fact, metformin may even contribute to weight loss in some individuals.

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