Nursing Elites

1. What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypernatremia

Correct answer: B

Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. One of the potential side effects of spironolactone therapy is hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia can lead to serious cardiac arrhythmias, making it crucial for healthcare providers to monitor potassium levels closely. Choices A, C, and D are incorrect because hypokalemia (low potassium levels), hyponatremia (low sodium levels), and hypernatremia (high sodium levels) are not typically associated with spironolactone use in patients with chronic heart failure.

2. A 40-year-old woman presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?

• A. Type 1 diabetes mellitus
• B. Type 2 diabetes mellitus
• C. Diabetes insipidus
• D. Hyperthyroidism

Correct answer: A

Rationale: The combination of symptoms including fatigue, polyuria, polydipsia, along with laboratory findings of hyperglycemia and ketonuria strongly suggest type 1 diabetes mellitus. In type 1 diabetes mellitus, there is a deficiency of insulin leading to high blood sugar levels (hyperglycemia) and the breakdown of fats producing ketones, causing ketonuria. Type 2 diabetes mellitus typically presents differently and is more common in older individuals. Diabetes insipidus is characterized by excessive thirst and urination due to a deficiency of antidiuretic hormone, distinct from the provided clinical scenario. Hyperthyroidism may present with some overlapping symptoms like fatigue, but it does not account for the specific laboratory findings of hyperglycemia and ketonuria seen in this case.

3. The nurse is caring for a client with hyperthyroidism. Which intervention should the nurse implement to manage the client's condition?

• A. Provide a high-calorie diet.
• B. Encourage frequent rest periods.
• C. Restrict fluid intake.
• D. Administer a stool softener.

Correct answer: B

Rationale: Encouraging frequent rest periods is essential in managing hyperthyroidism as it helps address the fatigue and hypermetabolic state commonly associated with this condition. Rest is crucial to support the body's recovery and reduce the stress on the thyroid gland. While nutrition is important in managing hyperthyroidism, providing a high-calorie diet is not the priority intervention. Restricting fluid intake is not typically necessary unless there are specific indications such as heart failure. Administering a stool softener is not directly related to managing hyperthyroidism.

4. When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?

• A. The nurse is indicating disapproval of the statement.
• B. The nurse is showing respect for the client's loss.
• C. Silence is mirroring the client's sadness.
• D. Silence enables the client to contemplate what was expressed.

Correct answer: D

Rationale: In therapeutic communication, silence can offer the client an opportunity to process their emotions and thoughts. By remaining silent, the nurse provides a space for the client to reflect on their own words, facilitating deeper exploration and understanding of their feelings.

5. A 60-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?

• A. Hepatitis C
• B. Primary biliary cirrhosis
• C. Hemochromatosis
• D. Wilson's disease

Correct answer: B

Rationale: The symptoms of fatigue, pruritus, jaundice, and elevated bilirubin and alkaline phosphatase levels are classic features of primary biliary cirrhosis, an autoimmune liver disease. Hepatitis C typically presents with different symptoms and findings, such as specific viral markers. Hemochromatosis and Wilson's disease involve iron overload and copper accumulation, respectively, leading to distinct clinical and laboratory findings, which do not match the presentation described in this case.

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