Nursing Elites

1. Nurse Noemi administers glucagon to her diabetic client and then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

• A. Oral anticoagulants
• B. Anabolic steroids
• C. Beta-adrenergic blockers
• D. Thiazide diuretics

Correct answer: A

Rationale: The correct answer is A: Oral anticoagulants. Glucagon may enhance the anticoagulant effect of oral anticoagulants, increasing the risk of bleeding. This interaction can be dangerous for the patient, leading to serious complications. Choices B, C, and D are incorrect because anabolic steroids, beta-adrenergic blockers, and thiazide diuretics do not typically interact adversely with glucagon. It is crucial for healthcare providers to be aware of potential drug interactions to ensure patient safety and optimal outcomes.

2. After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

• A. Primary hypothyroidism
• B. Graves' disease
• C. Thyrotoxicosis
• D. Euthyroidism

Correct answer: A

Rationale: Levothyroxine is the preferred agent for primary hypothyroidism because it provides the necessary replacement of thyroid hormone in patients with deficient thyroid function. Choice B, Graves' disease, is an autoimmune disorder that causes hyperthyroidism and is typically treated with antithyroid medications or radioactive iodine. Choice C, thyrotoxicosis, refers to the clinical state resulting from excessive thyroid hormone action and is not typically treated with levothyroxine. Choice D, euthyroidism, describes a normal thyroid function and would not require treatment with levothyroxine.

3. Which of the following best defines management?

• A. A manager is someone who ensures that employees complete their work.
• B. A manager controls the work of employees.
• C. A manager organizes and controls a group of employees to get work done.
• D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.

Correct answer: D

Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.

4. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

• A. Elevated blood glucose level and a low plasma bicarbonate
• B. Decreased urine output
• C. Increased respirations and an increase in pH
• D. Comatose state

Correct answer: A

Rationale: The correct answer is A: Elevated blood glucose level and a low plasma bicarbonate. Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketosis, and metabolic acidosis, reflected by a low plasma bicarbonate. Elevated blood glucose levels are a hallmark of DKA due to the body's inability to use glucose properly. Choices B, C, and D are incorrect. Decreased urine output is not a specific finding associated with DKA. Increased respirations and an increase in pH are not typical in DKA; in fact, respiratory compensation for the metabolic acidosis in DKA leads to Kussmaul breathing (deep, rapid breathing). A comatose state may occur in severe cases of DKA but is not a confirming finding for the diagnosis.

5. Which of the following clinical findings would be most concerning in a client with hypothyroidism?

• A. Bradycardia
• B. Dry skin
• C. Constipation
• D. Depression

Correct answer: A

Rationale: Bradycardia in a client with hypothyroidism is the most concerning finding as it may indicate severe hypothyroidism, leading to decreased heart rate. Bradycardia can be a sign of myxedema coma, a life-threatening condition that requires immediate medical attention. Dry skin, constipation, and depression are common symptoms associated with hypothyroidism but are not as acutely concerning as bradycardia.

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