Nursing Elites

1. 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.

2. Skillful communication is one behavior of an effective leader. Which of the following describes an effective method of communication?

• A. A unit manager meets with a new nurse to discuss what is going well and what improvements the new nurse can make.
• B. A unit manager meets with a new nurse to explain departmental policy.
• C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent further safety events.
• D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.

Correct answer: A

Rationale: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.

3. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?

• A. Administering insulin intravenously.
• B. Giving the client sips of water.
• C. Monitoring the client's urine output.
• D. Applying a heating pad to the client's abdomen.

Correct answer: A

Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.

4. When instructing the female client diagnosed with hyperparathyroidism about diet, Nurse Gina should stress the importance of which of the following?

• A. Restricting fluids
• B. Restricting sodium
• C. Forcing fluids
• D. Restricting potassium

Correct answer: C

Rationale: The correct answer is C: Forcing fluids. Nurse Gina should stress the importance of forcing fluids to help prevent kidney stones and hypercalcemia in clients with hyperparathyroidism. Restricting fluids (choice A) is not recommended as dehydration can worsen the condition. Restricting sodium (choice B) is not directly related to the management of hyperparathyroidism. Restricting potassium (choice D) is not typically necessary in hyperparathyroidism unless hyperkalemia is present.

5. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should the healthcare provider report?

• A. Hypotension
• B. Hyperglycemia
• C. Weight loss
• D. Hypokalemia

Correct answer: B

Rationale: In Cushing's syndrome, hyperglycemia is a common finding due to increased cortisol levels leading to insulin resistance. This can have serious implications such as diabetes mellitus and should be promptly reported for appropriate management. Hypotension (choice A) is more commonly associated with Addison's disease, not Cushing's syndrome. Weight gain rather than weight loss (choice C) is typically observed in clients with Cushing's syndrome. While hypokalemia (choice D) can occur in Cushing's syndrome due to excess cortisol affecting potassium levels, it is not as critical as hyperglycemia and may not be the priority for immediate reporting.

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