Nursing Elites

1. The client with chronic pancreatitis should be taught how to monitor for which of the following possible additional problems associated with pancreatic disease?

• A. Hypertension
• B. Diabetes
• C. Hypothyroidism
• D. Graves' disease

Correct answer: B

Rationale: The correct answer is diabetes. In chronic pancreatitis, the pancreas may become unable to produce sufficient insulin, leading to diabetes. This connection underscores the importance of monitoring blood sugar levels and understanding the signs and symptoms of diabetes in clients with chronic pancreatitis. Choice A, hypertension, is not directly associated with pancreatic disease but rather with cardiovascular health. Choice C, hypothyroidism, and Choice D, Graves' disease, are unrelated to pancreatic disease and are endocrine disorders affecting the thyroid gland.

2. What is the most common cause of acute renal failure?

• A. Shock
• B. Nephrotoxic drugs
• C. Enlarged prostate
• D. Diabetes

Correct answer: A

Rationale: The most common cause of acute renal failure is shock. In cases of shock, such as hypovolemic shock where there is low blood volume, the kidneys receive inadequate blood flow leading to acute renal failure. This can result in the kidneys starting to die within 20 minutes of low pressure. While nephrotoxic drugs can also cause acute renal failure, shock is more commonly associated with this condition. An enlarged prostate can lead to urinary retention but is not the most common cause of acute renal failure. Diabetes, on the other hand, can cause chronic kidney disease over time but is not typically the primary cause of acute renal failure.

3. A healthcare professional is reviewing a patient's current Lithium levels. Which of the following values is outside the therapeutic range?

• A. 1.0 mEq/L
• B. 1.1 mEq/L
• C. 1.2 mEq/L
• D. 1.3 mEq/L

Correct answer: D

Rationale: The correct answer is 1.3 mEq/L. The therapeutic range for Lithium levels typically falls between 0.6 to 1.2 mEq/L. Values below or above this range can lead to suboptimal treatment outcomes or toxicity. Choices A, B, and C are within the therapeutic range of 1.0-1.2 mEq/L, making them appropriate levels for patient care.

4. In a client with asthma who develops respiratory acidosis, what should the nurse expect the client's serum potassium level to be?

• A. normal
• B. elevated
• C. low
• D. unrelated to the pH

Correct answer: B

Rationale: In respiratory acidosis, the serum potassium level is expected to be elevated. This occurs because potassium shifts from cells into the bloodstream as a compensatory mechanism to maintain acid-base balance. Choices A, C, and D are incorrect. A normal potassium level is not expected in respiratory acidosis. A low potassium level is more commonly associated with alkalosis, not acidosis. The potassium level is indeed related to pH changes in respiratory acidosis, leading to the expected elevation.

5. Levothyroxine (Synthroid) is the drug of choice for thyroid replacement therapy in clients with hypothyroidism because:

• A. it is chemically stable, nonallergenic, and can be administered orally once a day.
• B. it is available in a wide range of concentrations to meet individual client requirements.
• C. it is a prodrug of T3.
• D. it has a long half-life.

Correct answer: A

Rationale: Levothyroxine (Synthroid) is the preferred medication for hypothyroidism due to its chemical stability, nonallergenic properties, and convenient once-daily oral administration. It is safe and effective with minimal side effects when appropriately dosed. Choice B is incorrect because while Levothyroxine is available in various concentrations, it is not the reason it is the drug of choice; the primary reason is its stability and nonallergenic nature. Choice C is wrong as Levothyroxine (T4) is not a prodrug of T3; it is converted to T3 in the body. Option D is inaccurate because Levothyroxine has a long half-life (around 7 days), enabling once-daily dosing, as opposed to a short half-life.

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