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. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Avoid taking the medication if you miss a meal.
• D. Take the medication before bedtime.

Correct answer: A

Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.

3. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

4. A client is diagnosed with hyperthyroidism. The nurse anticipates which of the following medications to be ordered?

• A. Levothyroxine
• B. Propylthiouracil
• C. Lithium
• D. Metoprolol

Correct answer: B

Rationale: The correct answer is B: Propylthiouracil. Propylthiouracil is an antithyroid medication used to manage hyperthyroidism by inhibiting the synthesis of thyroid hormones. Levothyroxine (Choice A) is typically used to treat hypothyroidism, the opposite of hyperthyroidism. Lithium (Choice C) is not used to treat hyperthyroidism but is commonly used to manage bipolar disorder. Metoprolol (Choice D) is a beta-blocker that may be used to manage symptoms like tachycardia associated with hyperthyroidism, but it is not the primary treatment for the condition.

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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