Nursing Elites

1. The healthcare provider is assessing a client with Addison's disease. Which of the following symptoms is consistent with this condition?

• A. Hypertension
• B. Hyperglycemia
• C. Hyperpigmentation
• D. Weight gain

Correct answer: C

Rationale: Hyperpigmentation is a characteristic symptom of Addison's disease. In Addison's disease, there is a decrease in cortisol production, leading to an increase in adrenocorticotropic hormone (ACTH) secretion by the pituitary gland. Excess ACTH can stimulate melanocytes, resulting in hyperpigmentation. Choices A, B, and D are not typically associated with Addison's disease. Hypertension is more commonly associated with conditions involving excess cortisol production, such as Cushing's syndrome. Hyperglycemia may occur in diabetes mellitus but is not a hallmark of Addison's disease. Weight loss, rather than weight gain, is a common symptom of Addison's disease due to decreased cortisol levels.

2. During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?

• A. At least once a week
• B. At least three times a week
• C. At least five times a week
• D. Every day

Correct answer: C

Rationale: Exercising at least five times a week is recommended to meet the goals of planned exercise for diabetic clients. This frequency helps in managing blood sugar levels effectively and improving overall health. Exercising once a week (Choice A) may not provide sufficient benefits or consistency required for diabetic clients. Exercising three times a week (Choice B) is better but may still fall short of the recommended frequency for optimal outcomes. Exercising every day (Choice D) may lead to burnout or overtraining if not properly balanced with rest days, which could be counterproductive for diabetic clients.

3. A client with DM is scheduled to have surgery. The nurse should plan to:

• A. Give the client a regular diet as ordered.
• B. Hold the client's insulin on the morning of surgery.
• C. Monitor the client's blood glucose level closely during the perioperative period.
• D. Have the client stop taking insulin 48 hours before surgery.

Correct answer: C

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. This is essential to ensure that the client's blood glucose levels remain within the target range and to prevent complications such as hypo- or hyperglycemia. Choices A, B, and D are incorrect because giving a regular diet as ordered, holding insulin on the morning of surgery, or stopping insulin 48 hours before surgery can lead to uncontrolled blood glucose levels, posing risks to the client's safety during the surgical procedure.

4. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?

• A. Administer insulin
• B. Encourage increased fluid intake
• C. Monitor for signs of dehydration
• D. Check blood glucose levels

Correct answer: D

Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.

5. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse implement?

• A. Encourage increased fluid intake
• B. Administer vasopressin
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. SIADH leads to excessive release of antidiuretic hormone (ADH), causing the body to retain water and diluting the sodium levels in the blood (hyponatremia). Restricting oral fluids helps prevent further water retention and worsening hyponatremia. Encouraging increased fluid intake (choice A) would exacerbate the problem by further diluting sodium levels. Administering vasopressin (choice B) is not indicated in SIADH, as the condition is characterized by excess ADH secretion. Monitoring for signs of dehydration (choice C) is not the priority in SIADH since the issue is water retention rather than dehydration.

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