Nursing Elites

1. During a physical assessment of a client with type 2 DM, a nurse notes the following findings: fasting blood glucose of 120 mg/dl, temperature of 101°F, pulse 88 bpm, respirations 22/min, and BP 140/84 mmHg. Which finding should concern the nurse the most?

• A. Pulse
• B. BP
• C. Respiration
• D. Temperature

Correct answer: D

Rationale: The correct answer is 'Temperature.' A temperature of 101°F indicates a fever, which can be a sign of infection. In individuals with diabetes, infections can lead to significant complications and affect blood glucose control. Monitoring and addressing infections promptly are crucial in individuals with diabetes to prevent worsening of their condition. Choice A, 'Pulse,' is within the normal range (60-100 bpm) and does not indicate an immediate concern. Choice B, 'BP,' while slightly elevated, is not as acutely concerning as an elevated temperature in this scenario. Choice C, 'Respiration,' falls within the normal range (12-20 breaths/min) and is not the most concerning finding among the options provided.

2. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?

• A. Serum calcium.
• B. Serum phosphorus.
• C. Serum potassium.
• D. Serum sodium.

Correct answer: C

Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.

3. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?

• A. Hyperglycemia
• B. Hypotension
• C. Hypokalemia
• D. Hyponatremia

Correct answer: B

Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.

4. Which of the following is an example of nonmaleficence in nursing practice?

• A. Administering pain medication as prescribed to prevent patient discomfort.
• B. Ensuring that a patient does not receive a treatment that they have refused.
• C. Ensuring that a patient receives appropriate care without causing harm.
• D. Encouraging a patient to express their concerns and fears about a procedure.

Correct answer: B

Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.

5. A client with hypothyroidism is being treated with levothyroxine. Which of the following symptoms would indicate that the client may be receiving too much medication?

• A. Bradycardia
• B. Weight gain
• C. Tachycardia
• D. Cold intolerance

Correct answer: C

Rationale: Tachycardia is a sign of excessive thyroid hormone replacement. Levothyroxine is used to treat hypothyroidism by supplementing thyroid hormone levels. If a client with hypothyroidism experiences symptoms of tachycardia, it suggests that they may be receiving an excessive amount of levothyroxine, causing hyperthyroidism. Bradycardia (Choice A) is more commonly associated with hypothyroidism, not excessive levothyroxine. Weight gain (Choice B) and cold intolerance (Choice D) are also typical symptoms of hypothyroidism and would not typically indicate overmedication.

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