Nursing Elites

1. The client is receiving dietary instructions for hypoparathyroidism. Which of the following dietary recommendations is appropriate?

• A. Increase intake of dairy products and green leafy vegetables
• B. Avoid foods high in calcium
• C. Consume a high-sodium diet
• D. Limit fluid intake to prevent fluid overload

Correct answer: A

Rationale: For clients with hypoparathyroidism, the appropriate dietary recommendation is to increase intake of calcium-rich foods like dairy products and green leafy vegetables to help manage hypocalcemia. This is because hypoparathyroidism leads to low levels of calcium in the blood, so increasing calcium intake through diet is essential. Choices B, C, and D are incorrect. Avoiding foods high in calcium (choice B) would exacerbate the hypocalcemia. Consuming a high-sodium diet (choice C) is not necessary for managing hypoparathyroidism. Limiting fluid intake (choice D) is not directly related to the dietary management of hypoparathyroidism.

2. 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.

3. A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:

• A. Phentolamine (Regitine)
• B. Methyldopa (Aldomet)
• C. Mannitol (Osmitrol)
• D. Felodipine (Plendil)

Correct answer: A

Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.

4. What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?

• A. Blurred vision.
• B. Diaphoresis.
• C. Nausea.
• D. Weakness.

Correct answer: B

Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.

5. Working in a stressful work environment, nursing requires effective nurse managers. Which of the following skills is necessary for a nurse manager to be effective?

• A. Clinical knowledge
• B. Managerial skills
• C. Patient care coordination
• D. Human resource training

Correct answer: B

Rationale: Managerial skills are crucial for nurse managers to be effective. They need to possess skills such as problem-solving and decision-making to handle various challenges in the healthcare setting. Clinical knowledge (choice A) is important for direct patient care but may not be the primary focus of a manager's role. Patient care coordination (choice C) is vital, but managerial skills are more directly related to a nurse manager's effectiveness. Human resource training (choice D) is helpful but not as essential as managerial skills in ensuring effective leadership in a nursing environment.

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