Nursing Elites

1. A healthcare professional is preparing to care for a client with a potassium deficit. The healthcare professional reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:

• A. Has renal failure.
• B. Requires nasogastric suction.
• C. Has a history of Addison's disease.
• D. Is taking a potassium-sparing diuretic.

Correct answer: B

Rationale: Nasogastric suction can lead to significant potassium loss due to the continuous drainage of gastric contents, increasing the risk of a potassium deficit. Choices A, C, and D do not directly result in the significant loss of potassium. Renal failure may lead to potassium retention rather than a deficit. Addison's disease is associated with adrenal insufficiency, not potassium depletion. Potassium-sparing diuretics, as the name suggests, typically help retain potassium rather than cause a deficit.

2. 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.

3. The client has undergone a thyroidectomy. Which of the following symptoms would indicate a potential complication?

• A. Bradycardia
• B. Tachycardia
• C. Hyperreflexia
• D. Hypocalcemia

Correct answer: D

Rationale: Hypocalcemia is a potential complication of thyroidectomy as it may occur if the parathyroid glands, responsible for calcium regulation, are inadvertently removed or damaged during the procedure. Bradycardia (slow heart rate) is not typically associated with thyroidectomy complications. Tachycardia (fast heart rate) is more commonly seen in hyperthyroidism. Hyperreflexia (exaggerated reflex responses) is not a typical complication of thyroidectomy.

4. 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.

5. Effective leaders must communicate a vision for the future. Which of the following is the best method for communicating a vision for the future?

• A. Involve others in creating the vision and connect daily work tasks to the vision.
• B. Encourage staff nurses to openly discuss practice and possible improvements.
• C. Critically analyze and discuss advances in practice with other nurses on staff.
• D. Actively listen to the recommendations of others.

Correct answer: A

Rationale: The best method for communicating a vision for the future is to involve others in creating the vision and connect daily work tasks to the vision. This approach fosters ownership and commitment among team members, as they feel part of the vision-building process and understand how their daily tasks contribute to achieving that vision. Choice B, encouraging staff nurses to openly discuss practice and possible improvements, is important for fostering communication but doesn't directly address creating and communicating a vision. Choice C, critically analyzing and discussing advances in practice with other nurses, focuses on professional development and knowledge sharing rather than specifically communicating a future vision. Choice D, actively listening to recommendations, is valuable for gathering input but may not be sufficient on its own for effectively communicating a future vision.

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