Nursing Elites

1. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

• A. Increasing saturated fat intake and fasting in the afternoon
• B. Increasing intake of vitamins B and D and taking iron supplements
• C. Eating a candy bar if lightheadedness occurs
• D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting

Correct answer: D

Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.

2. A client with hyperaldosteronism is at risk for which of the following electrolyte imbalances?

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

Correct answer: C

Rationale: In hyperaldosteronism, there is an excessive secretion of aldosterone, a hormone that promotes potassium excretion in the kidneys. This leads to low potassium levels in the blood, known as hypokalemia. Therefore, the correct answer is hypokalemia (Choice C). Hyperkalemia (Choice A) is the opposite condition, where there is high potassium levels in the blood and is not typically associated with hyperaldosteronism. Hyponatremia (Choice B) is a low sodium level, which is not directly related to aldosterone function. Hypercalcemia (Choice D) is an elevated calcium level and is not typically a direct result of hyperaldosteronism.

3. A new nurse is working on becoming a better follower. Which of the following recommendations should she implement?

• A. When you disagree with the manager, seek to determine the manager’s rationale.
• B. Share what you have learned only with newer nurses.
• C. Listen and reflect on your manager’s feedback.
• D. Seek to find a balance and manage your time and energy as you seek to learn about your specialty.

Correct answer: C

Rationale: Listening and reflecting on the manager’s feedback is crucial for a new nurse aiming to become a better follower. It allows the nurse to understand expectations, identify areas for improvement, and show respect for the manager's guidance. Choice A is incorrect as it focuses on resolving disagreements rather than improving followership skills. Choice B is incorrect as knowledge sharing should not be limited to specific groups. Choice D is incorrect as it addresses time management and learning about the specialty, which are important but not directly related to followership development.

4. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, Nurse Libby prepares to take emergency action to prevent the potential complication of:

• A. Thyroid storm.
• B. Cretinism.
• C. Myxedema coma.
• D. Hashimoto's thyroiditis.

Correct answer: C

Rationale: The scenario described with hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area is indicative of myxedema coma, a severe and life-threatening complication of hypothyroidism. Myxedema coma requires immediate emergency treatment to prevent further deterioration. Choice A, thyroid storm, is a complication of hyperthyroidism characterized by an increase in body temperature, heart rate, and blood pressure. Choice B, cretinism, refers to untreated congenital hypothyroidism leading to mental and physical growth retardation. Choice D, Hashimoto's thyroiditis, is an autoimmune condition leading to hypothyroidism but does not present with the acute, life-threatening symptoms described in the scenario.

5. A client with Graves' disease is prescribed propranolol. The nurse understands that the purpose of this medication is to:

• A. Treat the underlying cause of the disease
• B. Reduce thyroid hormone production
• C. Alleviate symptoms such as tachycardia and tremors
• D. Increase energy levels

Correct answer: C

Rationale: The correct answer is C: Alleviate symptoms such as tachycardia and tremors. Propranolol is a beta-blocker that helps manage symptoms like tachycardia (fast heart rate) and tremors in patients with Graves' disease. Choice A is incorrect because propranolol does not address the underlying cause of Graves' disease, which is autoimmune in nature. Choice B is incorrect because propranolol does not directly reduce thyroid hormone production; it mainly targets the symptoms. Choice D is incorrect because while propranolol may help with symptoms like tachycardia, it is not intended to increase energy levels.

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