Nursing Elites

1. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.

2. What is the nurse manager’s role in improving the quality of care on the unit?

• A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
• B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
• C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
• D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.

Correct answer: A

Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.

3. As a nurse manager rounds on the unit, he speaks with staff, patients, and family members. Later in the day, he is in a meeting with administration. During the conversations, he considers how these interactions impact the care provided to patients on the unit. Which of the following interpersonal activities best describes this manager's actions?

• A. Networking
• B. Employee development
• C. Coaching
• D. Monitoring

Correct answer: A

Rationale: The correct answer is 'Networking.' Networking involves interacting with others to exchange information and develop professional or social contacts. In this scenario, the nurse manager engages in networking by speaking with staff, patients, family members, and administration to understand their perspectives and build relationships. This activity helps the manager gather insights that can positively impact patient care. Choice B, 'Employee development,' focuses on activities aimed at improving staff skills and performance, which is not the primary focus of the manager's actions described. Choice C, 'Coaching,' involves providing guidance and support to individuals to help them achieve specific goals, which is not explicitly depicted in the scenario. Choice D, 'Monitoring,' typically involves overseeing or supervising activities to ensure compliance with standards or objectives, which does not fully capture the manager's proactive engagement in building relationships and gathering information through interactions.

4. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:

• A. The test needs to be repeated following a 12-hour fast.
• B. It appears you aren't following the prescribed diabetic diet.
• C. It tells us about your sugar control for the last 3 months.
• D. Your insulin regimen needs to be significantly altered.

Correct answer: C

Rationale: The correct answer is C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past 3 months. This test is used to assess long-term blood sugar control in individuals with diabetes. Choice A is incorrect because fasting is not required for an HbA1c test. Choice B is judgmental and not supported by the information provided. Choice D is not the most accurate statement to make based on the HbA1c result; adjusting insulin would depend on a more comprehensive assessment of the client's overall diabetes management.

5. The client has hyperparathyroidism. Which of the following dietary instructions should the nurse provide?

• A. Increase calcium intake
• B. Limit phosphorus intake
• C. Increase fluid intake
• D. Limit vitamin D intake

Correct answer: C

Rationale: The correct answer is to 'Increase fluid intake.' This is because increasing fluid intake helps prevent kidney stones, a common complication of hyperparathyroidism. While calcium is involved in the condition, increasing calcium intake is not recommended as it can exacerbate hypercalcemia, which is commonly present in hyperparathyroidism. Limiting phosphorus intake is not directly related to managing hyperparathyroidism. Limiting vitamin D intake is also not typically necessary in managing hyperparathyroidism, as it is usually a calcium and PTH-related issue.

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