Nursing Elites

1. When caring for a male client with diabetes insipidus, what does Nurse Juliet expect to administer?

• A. Vasopressin (Pitressin Synthetic)
• B. Furosemide (Lasix)
• C. Regular insulin
• D. 10% dextrose

Correct answer: A

Rationale: The correct answer is A: Vasopressin (Pitressin Synthetic). Vasopressin is the treatment of choice for diabetes insipidus as it replaces the deficient antidiuretic hormone. Furosemide (Lasix) (choice B) is a diuretic and would exacerbate fluid loss, making it inappropriate for diabetes insipidus. Regular insulin (choice C) is used for diabetes mellitus, not diabetes insipidus, which involves water balance rather than glucose regulation. 10% dextrose (choice D) is used to treat hypoglycemia, not diabetes insipidus.

2. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?

• A. Tap water
• B. Sterile water
• C. Sodium chloride
• D. Normal saline

Correct answer: C

Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.

3. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?

• A. Cool, clammy skin
• B. Distended neck veins
• C. Increased urine osmolarity
• D. Decreased serum sodium level

Correct answer: C

Rationale: Increased urine osmolarity is the best assessment finding supporting a nursing diagnosis of Deficient fluid volume in a male client with hyperglycemia. In hyperglycemia, there is increased glucose in the blood, which leads to osmotic diuresis. This results in the excretion of large amounts of urine that is concentrated (high osmolarity), leading to dehydration and fluid volume deficit. Cool, clammy skin (Choice A) is more indicative of poor perfusion, distended neck veins (Choice B) are associated with fluid volume excess, and decreased serum sodium level (Choice D) could be a result of dilutional hyponatremia due to fluid overload rather than deficient fluid volume.

4. The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?

• A. I should take my medication every day as prescribed.
• B. I need to avoid foods high in iodine.
• C. I can skip my medication on days when I feel fine.
• D. I should monitor my pulse regularly.

Correct answer: C

Rationale: Clients with hyperthyroidism should take their medication consistently and not skip doses, even if they feel well.

5. Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

• A. Tetany
• B. Hemorrhage
• C. Thyroid storm
• D. Laryngeal nerve damage

Correct answer: A

Rationale: The correct answer is 'Tetany.' Tetany is characterized by muscle twitching, tingling, and numbness, which are indicative of hypocalcemia. After a thyroidectomy, accidental removal or damage to the parathyroid glands can lead to decreased calcium levels, resulting in tetany. Choice B, 'Hemorrhage,' is incorrect as it typically presents with symptoms such as sudden swelling, increased pain, or drop in blood pressure. Choice C, 'Thyroid storm,' is incorrect as it involves a sudden exacerbation of hyperthyroidism, leading to symptoms like fever, tachycardia, and confusion. Choice D, 'Laryngeal nerve damage,' is incorrect as it would manifest with voice changes, difficulty swallowing, or respiratory distress, not the symptoms described in the scenario.

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