Nursing Elites

1. A nurse is assessing the learning needs of a client who is diagnosed with Addison's disease. Which statement indicates that the client needs further teaching?

• A. I should take my medications daily to replace necessary hormones
• B. I need to eat a diet high in protein and carbohydrates
• C. I should avoid drinking fluids with caffeine
• D. I should notify my healthcare provider if I start feeling dizzy

Correct answer: B

Rationale: The correct answer is B. A diet high in protein and carbohydrates is not specifically required for Addison's disease. The focus should be on maintaining a balanced diet that is rich in fruits, vegetables, whole grains, and adequate protein sources. Choice A is correct as adherence to medication therapy is crucial in managing Addison's disease. Choice C is correct as caffeine can exacerbate symptoms of Addison's disease. Choice D is correct as dizziness can be a sign of adrenal crisis in Addison's disease, and prompt notification of healthcare providers is essential.

2. The nurse is assessing a client who has a prescription for digoxin (Lanoxin). Which finding indicates that the client is at risk for digoxin toxicity?

• A. Heart rate of 60 beats per minute
• B. Blood pressure of 120/80 mm Hg
• C. Respiratory rate of 18 breaths per minute
• D. Serum potassium level of 3.0 mEq/L

Correct answer: D

Rationale: A low serum potassium level increases the risk of digoxin toxicity. Digoxin toxicity is more likely to occur in individuals with low potassium levels because potassium is crucial for proper heart function. A heart rate of 60 beats per minute, blood pressure of 120/80 mm Hg, and respiratory rate of 18 breaths per minute are within normal ranges and do not directly indicate an increased risk of digoxin toxicity.

3. A client is receiving a low dose of dopamine (Intropin) IV for the treatment of hypotension. Which indicator reflects that the medication is having the desired effect?

• A. Increased heart rate
• B. Increased urinary output
• C. Increased blood pressure
• D. Increased respiratory rate

Correct answer: C

Rationale: Increased blood pressure is the desired effect of administering dopamine (Intropin) to treat hypotension. Dopamine acts by stimulating adrenergic receptors, leading to vasoconstriction and increased cardiac output. This results in an elevation of blood pressure. Choices A, B, and D are incorrect as they do not directly reflect the therapeutic action of dopamine in treating hypotension. Increased heart rate may indicate the body compensating for low blood pressure, increased urinary output is more related to kidney function, and increased respiratory rate is often seen in response to respiratory issues, not the action of dopamine on hypotension.

4. A postoperative client returns to the nursing unit following a ureter lithotomy via a flank incision. Which potential nursing problem has the highest priority when planning nursing care for this client?

• A. Ineffective airway clearance
• B. Altered nutrition less than body requirements
• C. Fluid volume excess
• D. Activity intolerance

Correct answer: A

Rationale: The correct answer is 'Ineffective airway clearance.' Following a ureter lithotomy via a flank incision, the highest priority nursing problem is ensuring the client's airway remains clear. This is crucial for effective breathing and oxygenation. Altered nutrition, fluid volume excess, and activity intolerance are important to address but are of lower priority compared to maintaining a clear airway postoperatively.

5. The nurse believes that a client who frequently requests pain medication may have a substance abuse problem. Which intervention reflects the nurse's value of client autonomy over veracity?

• A. Administer the prescribed analgesic when requested
• B. Enroll the client in a substance abuse program
• C. Collaborate with the healthcare provider to provide a placebo
• D. Document the frequency of medication requests

Correct answer: A

Rationale: Administering the prescribed analgesic when requested reflects the nurse's value of client autonomy over veracity. This choice respects the client's right to manage their pain as they see fit. Enrolling the client in a substance abuse program (Choice B) assumes substance abuse without evidence and infringes on the client's autonomy. Providing a placebo (Choice C) violates the principle of beneficence and autonomy by deceiving the client. Documenting the frequency of medication requests (Choice D) is important for assessment but does not directly address the client's autonomy in managing their pain.

Similar Questions