Nursing Elites

1. A nurse manager works hard to keep employee morale high with the thought that this will lead to effective employees doing the best work they can. Which of the following theories does this best describe?

• A. Theory X
• B. Theory Y
• C. Servant leadership
• D. Scientific management

Correct answer: B

Rationale: Theory Y, as proposed by Douglas McGregor, emphasizes that employees are intrinsically motivated and seek responsibility. It suggests that high morale leads to high productivity, aligning with the nurse manager's actions. Theory X, on the other hand, assumes employees are inherently lazy and need to be closely monitored and controlled. Servant leadership focuses on serving others first and prioritizing their needs, which is not directly related to the scenario described. Scientific management, developed by Frederick Taylor, emphasizes efficiency and standardization through systematic study and organizational control, which is not the primary focus of the nurse manager's approach to boosting employee morale.

2. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:

• A. Increase metabolism
• B. Reduce anxiety
• C. Decrease heart rate
• D. Increase blood pressure

Correct answer: C

Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.

3. The healthcare provider is assessing a client with Addison's disease. Which of the following symptoms is consistent with this condition?

• A. Hypertension
• B. Hyperglycemia
• C. Hyperpigmentation
• D. Weight gain

Correct answer: C

Rationale: Hyperpigmentation is a characteristic symptom of Addison's disease. In Addison's disease, there is a decrease in cortisol production, leading to an increase in adrenocorticotropic hormone (ACTH) secretion by the pituitary gland. Excess ACTH can stimulate melanocytes, resulting in hyperpigmentation. Choices A, B, and D are not typically associated with Addison's disease. Hypertension is more commonly associated with conditions involving excess cortisol production, such as Cushing's syndrome. Hyperglycemia may occur in diabetes mellitus but is not a hallmark of Addison's disease. Weight loss, rather than weight gain, is a common symptom of Addison's disease due to decreased cortisol levels.

4. The nurse is preparing to administer NPH insulin to a client. The nurse should administer the insulin at which site for the best absorption?

• A. The deltoid muscle
• B. The anterior thigh
• C. The abdomen
• D. The gluteal muscle

Correct answer: C

Rationale: The abdomen is the preferred site for insulin injection due to its consistent absorption rate. Insulin injected into the abdomen is absorbed more consistently and predictably than in other sites. The deltoid muscle and the anterior thigh are not recommended for insulin injections due to inconsistent absorption rates. The gluteal muscle is avoided for insulin injections due to the risk of hitting the sciatic nerve or causing discomfort to the client.

5. A client with type 2 DM is being treated with metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication before bedtime.
• D. Avoid taking the medication if you miss a meal.

Correct answer: A

Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.

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