Nursing Elites

1. A nurse caring for a client with hypocalcemia would expect to note which of the following changes on the electrocardiogram?

• A. Widened T wave
• B. Prominent U wave
• C. Prolonged QT interval
• D. Shortened ST segment

Correct answer: C

Rationale: In hypocalcemia, a decreased level of calcium can lead to a prolonged QT interval on the ECG due to its role in myocardial repolarization. A widened T wave (Choice A) is typically seen in hyperkalemia. A prominent U wave (Choice B) is associated with hypokalemia. A shortened ST segment (Choice D) is not a typical ECG finding in hypocalcemia.

2. 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.

3. Which instruction about insulin administration should Nurse Kate give to a client?

• A. Always follow the same order when drawing up different insulins into the syringe.
• B. Shake the vials before withdrawing the insulin.
• C. Store unopened vials of insulin in the refrigerator at recommended temperatures.
• D. Discard the intermediate-acting insulin if it appears cloudy.

Correct answer: A

Rationale: The correct answer is A. Consistently following the same order when drawing up different insulins helps to prevent medication errors. Option B is incorrect because shaking insulin vials could cause bubbles to form, leading to inaccurate dosing. Option C is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness. Option D is incorrect because cloudy appearance in intermediate-acting insulin may indicate the presence of insulin crystals, which can affect its potency, but this does not necessarily mean it should be discarded without consulting a healthcare provider.

4. The healthcare provider is monitoring a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the healthcare provider include in the care plan?

• A. Encourage oral fluids
• B. Restrict fluid intake
• C. Administer potassium supplements
• D. Increase sodium intake

Correct answer: B

Rationale: The correct intervention for a client with SIADH is to restrict fluid intake. SIADH leads to water retention and dilution of sodium levels in the body, resulting in hyponatremia. Restricting fluid intake helps prevent further dilutional hyponatremia. Encouraging oral fluids (Choice A) would exacerbate the condition by further increasing fluid retention. Administering potassium supplements (Choice C) is not directly related to managing SIADH. Increasing sodium intake (Choice D) is contraindicated because it can worsen hyponatremia in clients with SIADH.

5. A client with type 2 DM is prescribed 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. Avoid taking the medication if you miss a meal.
• D. Take the medication before bedtime.

Correct answer: A

Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.

Similar Questions