Nursing Elites

1. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?

• A. Encourage increased fluid intake
• B. Administer hypertonic saline
• 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. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.

2. A client with type 2 diabetes mellitus is taking metformin. The nurse should monitor the client for which of the following potential side effects?

• A. Lactic acidosis
• B. Hypokalemia
• C. Hyperglycemia
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or other predisposing factors. Monitoring for signs and symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or irregular heartbeat, is crucial when a client is taking metformin. Choice B, hypokalemia, is not a common side effect of metformin. Choice C, hyperglycemia, is contrary to the intended effect of metformin, which is to lower blood glucose levels. Choice D, weight gain, is not typically associated with metformin use; in fact, metformin may even contribute to weight loss in some individuals.

3. The client has received IV solutions for three (3) days through a 20-gauge IV catheter placed in the left cephalic vein. On morning rounds, the nurse notes the IV site is tender to palpation and a red streak has formed. Which action should the nurse implement first?

• A. Start a new IV in the right hand.
• B. Discontinue the intravenous line.
• C. Complete an incident record.
• D. Place a warm washcloth over the site.

Correct answer: B

Rationale: The first action should be to discontinue the intravenous line to prevent further complications such as infection or thrombophlebitis. Starting a new IV in the right hand is not the priority as addressing the current issue is important. Completing an incident record can be done after addressing the immediate concern of the IV site. Placing a warm washcloth over the site does not address the red streak and tenderness, which may indicate an infection that requires discontinuation of the IV line.

4. A client with diabetes mellitus is being educated on the importance of foot care. Which of the following instructions should the nurse include?

• A. Soak your feet daily to maintain cleanliness.
• B. Wear tight-fitting shoes to protect your feet.
• C. Apply lotion between your toes to prevent dryness.
• D. Inspect your feet daily for any cuts or sores.

Correct answer: D

Rationale: The correct answer is to instruct the client to inspect their feet daily for any cuts or sores. This is crucial for individuals with diabetes as they are at a higher risk of developing foot problems. Soaking feet daily can lead to skin breakdown and infections, making choice A incorrect. Tight-fitting shoes can cause pressure points and increase the risk of foot injuries, so choice B is incorrect. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections, making choice C incorrect.

5. A healthcare professional is focusing on improving the ability to multitask without losing focus and to turn problems into opportunities. Which of the following leadership theories describes the professional's focus?

• A. Emotional intelligence
• B. Motivation theory
• C. Situational leadership theory
• D. Transformational leadership theory

Correct answer: B

Rationale: Motivation theory explains that individuals act based on what they want to achieve, focusing on goals and desires. In this scenario, the healthcare professional's emphasis on improving multitasking skills and problem-solving aligns with the essence of motivation theory. Emotional intelligence primarily pertains to understanding and managing emotions, not specifically related to multitasking and problem-solving. Situational leadership theory emphasizes adapting leadership styles based on the situation and followers, not directly related to individual focus improvement. Transformational leadership theory focuses on inspiring and motivating followers to achieve common goals rather than individual task management and problem-solving skills.

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