Nursing Elites

1. The healthcare provider is monitoring a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the healthcare provider include in the care plan?

• A. Encourage oral fluids
• B. Restrict fluid intake
• C. Administer potassium supplements
• D. Increase sodium intake

Correct answer: B

Rationale: The correct intervention for a client with SIADH is to restrict fluid intake. SIADH leads to water retention and dilution of sodium levels in the body, resulting in hyponatremia. Restricting fluid intake helps prevent further dilutional hyponatremia. Encouraging oral fluids (Choice A) would exacerbate the condition by further increasing fluid retention. Administering potassium supplements (Choice C) is not directly related to managing SIADH. Increasing sodium intake (Choice D) is contraindicated because it can worsen hyponatremia in clients with SIADH.

2. A client with diabetes mellitus is scheduled for surgery. The nurse should prioritize which of the following preoperative actions?

• A. Administer a full dose of insulin before surgery
• B. Hold all oral hypoglycemic agents the day before surgery
• C. Monitor blood glucose levels closely before surgery
• D. Instruct the client to avoid all fluids the morning of surgery

Correct answer: C

Rationale: Monitoring blood glucose levels closely before surgery is the priority for a client with diabetes mellitus. This allows for early detection of any abnormalities and helps prevent hypo- or hyperglycemia complications that can arise during the perioperative period. Option A is incorrect because insulin dosing should be individualized based on the client's current blood glucose levels and the surgical plan. Option B is incorrect as abruptly holding oral hypoglycemic agents can lead to uncontrolled blood glucose levels. Option D is incorrect as adequate fluid intake is important for the client's hydration status and overall well-being before surgery.

3. The client with DM who is taking insulin develops a fever and becomes confused. Which action should the nurse take first?

• A. Check the client's blood glucose level.
• B. Administer a fever-reducing medication.
• C. Give the client fluids to drink.
• D. Notify the health care provider.

Correct answer: A

Rationale: In a client with diabetes mellitus (DM) taking insulin, the development of fever and confusion may indicate hyperglycemia or diabetic ketoacidosis. Checking the blood glucose level is the priority action in this situation. This will help determine if the symptoms are related to high blood sugar levels, guiding further interventions. Administering a fever-reducing medication (choice B) addresses only the symptom of fever and does not address the underlying cause. Providing fluids to drink (choice C) is important but should come after addressing the potential hyperglycemia or diabetic ketoacidosis. Notifying the health care provider (choice D) can be important, but immediate action to evaluate and manage the client's condition should precede contacting the provider.

4. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?

• A. Administer intravenous fluids
• B. Provide a warming blanket
• C. Administer levothyroxine intravenously
• D. Place the client in Trendelenburg position

Correct answer: C

Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.

5. Scientific management and human relations-based approach are two major theoretical management schools of thought. Which of the following best describes the scientific model of management?

• A. A nurse manager considers methods of motivating the staff to do their assigned tasks.
• B. A nurse manager commends staff for the work they do, reminding them of the importance of their work and the lives they have saved.
• C. A nurse manager analyzes the role of each staff member on the unit to determine ways to increase efficiency.
• D. A conflict between two staff nurses has impacted an entire unit. The unit manager meets with the nurses and entire staff to promote mutual understanding.

Correct answer: C

Rationale: The correct answer is C because scientific management focuses on improving efficiency through the analysis of tasks and work processes. Choice A is more aligned with a human relations-based approach, which emphasizes motivation and relationships. Choice B reflects recognition and morale boosting, which is also characteristic of the human relations approach. Choice D involves conflict resolution and promoting mutual understanding, which is related to the human relations approach rather than scientific management.

Similar Questions