Nursing Elites

1. A nurse manager has detected a potential problem with staffing and has asked staff members for their thoughts on the matter. Which of the following best describes the informational activity this manager is engaging in?

• A. Spokesperson
• B. Reporting
• C. Monitoring
• D. Job analysis and redesign

Correct answer: C

Rationale: The correct answer is C: 'Monitoring.' Monitoring involves regularly checking and observing the status of a unit or situation. In this scenario, the nurse manager is actively seeking feedback from staff members to assess and keep track of the staffing situation. Choice A, 'Spokesperson,' refers to a role where someone represents or speaks on behalf of a group or organization, which is not the primary activity in this case. Choice B, 'Reporting,' typically involves presenting information or data about a specific topic or issue but does not capture the ongoing observation and assessment aspect seen in monitoring. Choice D, 'Job analysis and redesign,' involves assessing and restructuring job roles, responsibilities, and tasks, which is not directly related to the action of monitoring staffing levels.

2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which 'related-to' phrase should the nurse add?

• A. Related to bone demineralization resulting in pathologic fractures
• B. Related to exhaustion secondary to an accelerated metabolic rate
• C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
• D. Related to tetany secondary to a decreased serum calcium level

Correct answer: A

Rationale: The correct answer is A: 'Related to bone demineralization resulting in pathologic fractures.' In chronic hyperparathyroidism, bone demineralization occurs due to the excessive release of parathyroid hormone, leading to increased calcium resorption from bones. This process weakens the bones, making the client prone to pathologic fractures. Choices B, C, and D are incorrect because they do not directly relate to the increased risk of injury associated with chronic hyperparathyroidism. Exhaustion, edema, dry skin, and tetany are not the primary risks for injury in this client population.

3. 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.

4. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?

• A. Serum glucose of 180 mg/dL
• B. Serum bicarbonate of 22 mEq/L
• C. Blood pH of 7.25
• D. Urine specific gravity of 1.020

Correct answer: C

Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.

5. What is the lowest fasting plasma glucose level suggestive of a diagnosis of DM?

• A. 90 mg/dl.
• B. 115 mg/dl.
• C. 126 mg/dl.
• D. 180 mg/dl.

Correct answer: C

Rationale: A fasting plasma glucose level of 126 mg/dl or higher is diagnostic of diabetes mellitus. Choice A (90 mg/dl) is too low to indicate diabetes. Choice B (115 mg/dl) is also below the diagnostic threshold for diabetes. Choice D (180 mg/dl) is above the diagnostic threshold and would indicate uncontrolled diabetes, not the lowest level suggestive of a diagnosis.

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