Nursing Elites

1. In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:

• A. Serum glucose level.
• B. Hair loss.
• C. Bone mineralization.
• D. Menstrual flow.

Correct answer: A

Rationale: The correct answer is A: Serum glucose level. In Cushing's syndrome, there is excess cortisol production which can lead to hyperglycemia. Successful treatment of Cushing's syndrome aims to normalize cortisol levels, resulting in a decline in serum glucose levels. Choice B, hair loss, is not specifically associated with Cushing's syndrome or its treatment. Choice C, bone mineralization, is often compromised in Cushing's syndrome due to the effects of excess cortisol on bones; however, successful treatment would aim to improve bone health rather than decline it. Choice D, menstrual flow, is not directly linked to Cushing's syndrome or its treatment, so a decline in menstrual flow would not be an expected outcome of successful treatment.

2. The healthcare provider is assessing a client with hypothyroidism. Which of the following clinical findings would the healthcare provider expect?

• A. Tachycardia
• B. Weight loss
• C. Cold intolerance
• D. Diaphoresis

Correct answer: C

Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a reduced ability to regulate body temperature. As a result, individuals with hypothyroidism often feel cold, especially in their extremities. Tachycardia (A) is more commonly associated with hyperthyroidism due to the increased metabolic rate. Weight loss (B) is also a typical finding in hyperthyroidism, as the body burns calories at a faster rate. Diaphoresis (D), excessive sweating, is not a typical symptom of hypothyroidism.

3. A healthcare professional is monitoring a client newly diagnosed with DM for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if blood glucose levels are not adequately managed?

• A. Polyuria
• B. Diaphoresis
• C. Pedal edema
• D. Proteinuria

Correct answer: D

Rationale: Proteinuria is the correct answer because it indicates kidney damage, which is a common complication of uncontrolled diabetes. Elevated blood glucose levels over time can damage the kidneys, leading to proteinuria. Polyuria (excessive urination) is a symptom of diabetes but does not specifically indicate a risk for chronic complications. Diaphoresis (excessive sweating) and pedal edema (swelling of the lower limbs) are not direct indicators of chronic complications related to uncontrolled diabetes.

4. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.

• A. Place the solution on an IV pump at the prescribed rate.
• B. Monitor blood glucose every twelve (12) hours.
• C. Weigh the client weekly, first thing in the morning.
• D. Change the IV tubing every three (3) days.

Correct answer: D

Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.

5. The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?

• A. Soak your feet in hot water every night.
• B. Walk barefoot whenever possible.
• C. Use a heating pad to warm your feet.
• D. Wear comfortable shoes that allow air circulation.

Correct answer: D

Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.

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