Nursing Elites

1. A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?

• A. Hyperglycemia
• B. Bradycardia
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: The correct answer is hyperglycemia. Prednisone, a corticosteroid, can lead to elevated blood sugar levels as a side effect, particularly in patients with diabetes or those predisposed to developing diabetes. Monitoring for hyperglycemia is crucial to prevent complications like diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.

2. A client with newly diagnosed diabetes mellitus is receiving teaching on foot care. Which instruction should the nurse include?

• A. Walk barefoot whenever possible to toughen your feet.
• B. Soak your feet in hot water daily to improve circulation.
• C. Trim your toenails straight across to prevent ingrown toenails.
• D. Use a heating pad to keep your feet warm.

Correct answer: C

Rationale: Correctly trimming toenails straight across is crucial in preventing ingrown toenails and potential infections in individuals with diabetes. Ingrown toenails can lead to complications, so it is essential for diabetic clients to practice proper nail care to avoid these issues. Choices A, B, and D are incorrect. Walking barefoot can increase the risk of foot injuries, soaking feet in hot water can cause burns or skin damage, and using a heating pad can lead to burns or injuries due to decreased sensation in the feet, which is common in diabetes.

3. A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The symptoms of abdominal pain, bloating, diarrhea improving with fasting, and a history of iron deficiency anemia are characteristic of celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. The improvement with fasting may be due to the temporary avoidance of gluten-containing foods. Irritable bowel syndrome, lactose intolerance, and Crohn's disease do not typically present with improvement of symptoms with fasting or have a clear association with iron deficiency anemia.

4. The healthcare provider is assessing a client with Cushing's syndrome. Which clinical manifestation should the healthcare provider expect to find?

• A. Hyperpigmentation of the skin.
• B. Hypotension.
• C. Moon face and buffalo hump.
• D. Weight loss.

Correct answer: C

Rationale: The correct answer is C: Moon face and buffalo hump. In Cushing's syndrome, excess production of corticosteroids leads to redistribution of fat, particularly in the face (moon face) and between the shoulders (buffalo hump). Hyperpigmentation of the skin is actually associated with Addison's disease, not Cushing's syndrome (choice A). Hypotension is not a typical finding in Cushing's syndrome; instead, hypertension is more commonly seen due to the effects of excess cortisol (choice B). Weight gain, rather than weight loss, is a common symptom of Cushing's syndrome due to the metabolic disturbances caused by excess cortisol (choice D).

5. A patient with epilepsy is prescribed phenytoin. What is the primary side effect the nurse should monitor for?

• A. Hypotension
• B. Gingival hyperplasia
• C. Bradycardia
• D. Hyperkalemia

Correct answer: B

Rationale: Gingival hyperplasia, or overgrowth of the gums, is a common side effect of phenytoin. Patients should maintain good oral hygiene to minimize this effect.

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