Nursing Elites

1. The healthcare provider is caring for a client with pheochromocytoma. Which of the following interventions should the healthcare provider implement?

• A. Administer beta-blockers to control blood pressure
• B. Encourage a high-sodium diet
• C. Monitor for signs of hyperglycemia
• D. Restrict fluid intake to prevent edema

Correct answer: A

Rationale: The correct intervention for a client with pheochromocytoma is to administer beta-blockers to control blood pressure. Pheochromocytoma is a catecholamine-secreting tumor that can cause severe hypertension. Beta-blockers are used to block the effects of catecholamines and help control blood pressure in these clients. Encouraging a high-sodium diet (Choice B) would not be appropriate as it can worsen hypertension. Monitoring for signs of hyperglycemia (Choice C) is not directly related to managing pheochromocytoma. Restricting fluid intake (Choice D) may lead to dehydration and is not a recommended intervention for this condition.

2. A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?

• A. The client taking diuretics
• B. The client with renal failure
• C. The client with an ileostomy
• D. The client who requires gastrointestinal suctioning

Correct answer: B

Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.

3. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?

• A. Administer desmopressin while the suspension is cold.
• B. Your condition isn't chronic, so you won't need to wear a medical identification bracelet.
• C. You may not be able to use desmopressin nasally if you have nasal discharge or blockage.
• D. You won't need to monitor your fluid intake and output after you start taking desmopressin.

Correct answer: C

Rationale: The correct instruction is choice C: 'You may not be able to use desmopressin nasally if you have nasal discharge or blockage.' Nasal congestion or blockage can interfere with the absorption of nasally administered desmopressin. Choices A, B, and D are incorrect. Choice A is unnecessary as the temperature of the suspension does not impact desmopressin administration. Choice B is incorrect as wearing a medical identification bracelet is essential for individuals with diabetes insipidus to alert healthcare providers in case of emergencies. Choice D is incorrect as monitoring fluid intake and output is crucial when taking desmopressin to ensure proper hydration and medication effectiveness.

4. The client with type 1 diabetes mellitus is being educated by the nurse about the signs of hypoglycemia. Which of the following symptoms should the client be instructed to report immediately?

• A. Shakiness
• B. Sweating
• C. Confusion
• D. Increased thirst

Correct answer: C

Rationale: Confusion is a critical symptom of hypoglycemia that may indicate a more severe drop in blood glucose levels. Immediate reporting of confusion is crucial as it could progress rapidly to unconsciousness or seizures, necessitating prompt intervention. Shakiness and sweating are common early signs of hypoglycemia but may not require immediate intervention unless other severe symptoms present. Increased thirst is more indicative of hyperglycemia rather than hypoglycemia, and while it should be monitored, it is not a symptom requiring immediate reporting.

5. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• A. 1130 and 1330.
• B. 1330 and 1930.
• C. 1530 and 2130.
• D. 1730 and 2330.

Correct answer: C

Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.

Similar Questions