Nursing Elites

1. A healthcare professional reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the healthcare professional note on the electrocardiogram as a result of the laboratory value?

• A. U waves
• B. Absent P waves
• C. Elevated T waves
• D. Elevated ST segment

Correct answer: A

Rationale: The correct answer is A: U waves. A low potassium level (hypokalemia) can manifest as U waves on an ECG. U waves are small, extra deflections seen after the T wave and may indicate cardiac irritability. Absent P waves (Choice B) are associated with conditions like atrial fibrillation. Elevated T waves (Choice C) can be seen in hyperkalemia, not hypokalemia. Elevated ST segment (Choice D) is not typically associated with low potassium levels but can be seen in conditions like myocardial infarction.

2. When caring for a female client with a history of hypoglycemia, Nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?

• A. Sulfisoxazole (Gantrisin)
• B. Mexiletine (Mexitil)
• C. Prednisone (Orasone)
• D. Lithium carbonate (Lithobid)

Correct answer: A

Rationale: The correct answer is A, Sulfisoxazole (Gantrisin). Sulfisoxazole is known to potentiate hypoglycemia, making it unsafe for clients with a history of hypoglycemia. Choice B, Mexiletine, is a medication used to treat certain heart rhythm problems and is not associated with hypoglycemia. Choice C, Prednisone, is a corticosteroid and does not potentiate hypoglycemia. Choice D, Lithium carbonate, is commonly used to treat bipolar disorder and does not typically potentiate hypoglycemia. Therefore, the drug that Nurse Ruby should avoid in this case is Sulfisoxazole (Gantrisin) to prevent worsening the client's hypoglycemic condition.

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 client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:

• A. I need to skip meals if my blood glucose level is elevated.
• B. I need to eat a small meal or snack every 2 to 3 hours.
• C. I need to avoid using concentrated sweets in my diet.
• D. I need to eat a high-protein, low-carbohydrate diet.

Correct answer: C

Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.

5. 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.

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