Nursing Elites

1. The nurse is caring for a client with hyperparathyroidism. Which of the following clinical manifestations is consistent with this condition?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperphosphatemia

Correct answer: B

Rationale: In hyperparathyroidism, there is an overproduction of parathyroid hormone, leading to increased calcium levels in the blood (hypercalcemia). This occurs as the parathyroid hormone stimulates the release of calcium from the bones and enhances calcium absorption in the intestines and kidneys. Therefore, the correct answer is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not consistent with hyperparathyroidism, as this condition is characterized by high calcium levels. Hypokalemia (Choice C) and hyperphosphatemia (Choice D) are not typically associated with hyperparathyroidism and are not primary manifestations of this condition.

2. Which of the following best describes the nurse's role in maintaining patient dignity?

• A. The nurse ensures that the patient is treated with respect and that their personal beliefs and values are considered in their care.
• B. The nurse maintains the patient's dignity by ensuring privacy during personal care activities.
• C. The nurse ensures that the patient's personal information is kept private and only shared with those directly involved in their care.
• D. The nurse ensures that the patient is involved in decisions about their care and that their preferences are respected.

Correct answer: A

Rationale: The correct answer is A. The nurse's role in maintaining patient dignity goes beyond just privacy during personal care activities. It involves treating the patient with respect, considering their personal beliefs and values in their care. While privacy is important for dignity, respecting personal beliefs and values is equally crucial. Choice B focuses solely on privacy, overlooking the broader aspects of dignity maintenance. Choices C and D, although important in patient care, do not fully capture the comprehensive approach needed for maintaining patient dignity as described in choice A.

3. Which of the following ethical principles is involved when a healthcare provider allows a patient to refuse treatment?

• A. Autonomy
• B. Nonmaleficence
• C. Beneficence
• D. Justice

Correct answer: A

Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make their own decisions, including the right to refuse treatment. This principle acknowledges the patient's self-governance and independence in making choices about their own healthcare. Choice B, Nonmaleficence, refers to the ethical principle of doing no harm and ensuring patient safety. Choice C, Beneficence, involves promoting the patient's well-being and acting in their best interest. Choice D, Justice, pertains to fairness and equitable distribution of healthcare resources.

4. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:

• A. Gives small continuous doses of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
• B. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
• C. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
• D. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.

Correct answer: A

Rationale: The correct answer is A. An external insulin pump delivers small continuous doses of regular insulin subcutaneously throughout the day to meet the basal insulin needs. The client can also self-administer a bolus dose with an additional dosage from the pump before each meal to cover the mealtime insulin needs. Option B is incorrect as insulin pumps do not typically release programmed doses of insulin into the bloodstream at specific intervals; instead, they infuse insulin subcutaneously. Option C is incorrect as insulin pumps are not surgically attached to the pancreas; they are worn externally. Option D is incorrect as NPH insulin is not commonly used in insulin pumps, and the pumps do not continuously infuse insulin directly into the bloodstream but rather subcutaneously.

5. The healthcare professional is educating a client with Cushing's syndrome about dietary management. Which of the following instructions should the healthcare professional include?

• A. Increase sodium intake
• B. Limit protein intake
• C. Limit calcium intake
• D. Increase potassium intake

Correct answer: D

Rationale: For clients with Cushing's syndrome, they are at risk of developing hypokalemia due to increased excretion of potassium. Therefore, it is essential to advise them to increase their potassium intake. Choices A, B, and C are incorrect because: A) Increasing sodium intake can worsen fluid retention and hypertension common in Cushing's syndrome. B) Limiting protein intake is not necessary unless there are specific kidney issues that require protein restriction. C) Limiting calcium intake is not typically recommended unless there are underlying conditions such as hypercalcemia.

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