Nursing Elites

1. The nurse is caring for a client with diabetes insipidus. Which of the following laboratory findings should the nurse monitor?

• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: In diabetes insipidus, there is excessive excretion of water leading to dehydration. Monitoring serum sodium levels is crucial because these clients often experience hypernatremia (elevated serum sodium levels) due to the loss of relatively more water than sodium, resulting in a sodium concentration imbalance. While monitoring serum potassium, calcium, and magnesium levels is also important in various conditions, they are not the primary focus in diabetes insipidus.

2. What health concerns should Nurse Oliver expect a client with hypothyroidism to report?

• A. Increased appetite and weight loss
• B. Puffiness of the face and hands
• C. Nervousness and tremors
• D. Thyroid gland swelling

Correct answer: B

Rationale: Puffiness of the face and hands is a classic symptom of hypothyroidism. This occurs due to fluid retention and is commonly observed in individuals with an underactive thyroid gland. Increased appetite and weight loss (Choice A) are more indicative of hyperthyroidism, where there is an overproduction of thyroid hormones leading to increased metabolism. Nervousness and tremors (Choice C) are associated with hyperthyroidism, not hypothyroidism. Thyroid gland swelling (Choice D) typically indicates goiter, which can be present in both hyperthyroidism and hypothyroidism but is not a specific symptom that clients with hypothyroidism commonly report.

3. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:

• A. Increase metabolism
• B. Reduce anxiety
• C. Decrease heart rate
• D. Increase blood pressure

Correct answer: C

Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.

4. A client with diabetes insipidus is being treated with desmopressin. The nurse should monitor for which of the following side effects?

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

Correct answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used in diabetes insipidus, can cause water retention by increasing water reabsorption in the kidneys. This excess water retention can lead to dilutional hyponatremia, where sodium levels in the body become too low. Monitoring for hyponatremia is crucial to prevent complications such as neurological symptoms. Choices B, C, and D are incorrect because desmopressin is not known to cause hypernatremia, hypokalemia, or hypercalcemia.

5. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager’s actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.

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