Nursing Elites

1. The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?

• A. Seafood
• B. Spinach
• C. Bananas
• D. Oatmeal

Correct answer: A

Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.

2. A client with diabetes mellitus visits a health care clinic. The client's diabetes was previously well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone (Deltasone)
• B. Atenolol (Tenormin)
• C. Phenelzine (Nardil)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone, a corticosteroid, can increase blood glucose levels by promoting gluconeogenesis and decreasing glucose uptake by cells. This medication can lead to hyperglycemia in patients, especially those with diabetes mellitus. Atenolol (Tenormin) is a beta-blocker and is not known to significantly affect blood glucose levels. Phenelzine (Nardil) is a monoamine oxidase inhibitor used to treat depression and anxiety disorders; it does not typically impact blood glucose levels. Allopurinol (Zyloprim) is a xanthine oxidase inhibitor used to manage gout and does not interfere with blood glucose regulation.

3. A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:

• A. Apples
• B. Carrots
• C. Spinach
• D. Avocado

Correct answer: A

Rationale: The correct answer is 'Apples.' Apples are the lowest in potassium among the given options. Carrots, spinach, and avocados are all higher in potassium content compared to apples. Carrots and spinach are vegetables known to have a moderate amount of potassium. Avocados, on the other hand, are a high-potassium fruit and would not be the lowest in potassium among the choices provided.

4. A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be:

• A. High risk for deficient fluid volume
• B. Deficient knowledge: disease process and treatment
• C. Imbalanced nutrition: less than body requirements
• D. Disabled family coping: compromised

Correct answer: A

Rationale: The priority nursing diagnosis for a client with diabetes mellitus (DM) experiencing hyperglycemia would be 'High risk for deficient fluid volume.' Hyperglycemia can lead to osmotic diuresis, causing significant fluid loss and an increased risk of deficient fluid volume. This nursing diagnosis addresses the immediate physiological concern related to fluid balance.\n\nChoice B, 'Deficient knowledge: disease process and treatment,' focuses on the client's understanding of DM, which is important but not the priority when the client is at risk of fluid volume deficit.\n\nChoice C, 'Imbalanced nutrition: less than body requirements,' pertains to inadequate intake of nutrients, which is not the priority concern when fluid volume deficit poses a more immediate threat.\n\nChoice D, 'Disabled family coping: compromised,' addresses a psychosocial aspect and is not the priority over the critical physiological issue of fluid volume deficit in a client with hyperglycemia.

5. 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.

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