Nursing Elites

1. What signs/symptoms would the nurse expect to find in the client diagnosed with an insulinoma?

• A. Nervousness, jitteriness, and diaphoresis
• B. Flushed skin, dry mouth, and tented skin turgor
• C. Polyuria, polydipsia, polyphagia
• D. Hypertension, tachycardia, and feeling hot

Correct answer: A

Rationale: The correct answer is A: 'Nervousness, jitteriness, and diaphoresis.' Insulinomas cause hypoglycemia due to excessive insulin production, leading to symptoms such as nervousness (from the sympathetic response to hypoglycemia), jitteriness, and diaphoresis (sweating). Choices B, C, and D are incorrect. Flushed skin, dry mouth, and tented skin turgor (Choice B) are not typical signs of insulinoma. Polyuria, polydipsia, and polyphagia (Choice C) are classic symptoms of diabetes mellitus, not insulinoma. Hypertension, tachycardia, and feeling hot (Choice D) are more indicative of hyperthyroidism or a hypermetabolic state, rather than an insulinoma presentation.

2. The HCP orders cultures of the urethral urine, bladder urine, and prostatic fluid. Which instructions would the nurse teach to achieve the first two (2) specimens?

• A. Collect the first 15 mL in one jar and then the next 50 mL in another
• B. Collect three (3) early morning, clean voided urine specimens
• C. Collect the specimens after the HCP massages the prostate
• D. Collect a routine urine specimen for analysis

Correct answer: A

Rationale: The correct answer is to collect the first 15 mL in one jar and then the next 50 mL in another. This method allows for accurate cultures of urethral and bladder urine. Choice B is incorrect because it does not specify the correct method for collecting urethral and bladder urine separately. Choice C is incorrect because prostatic fluid is a separate specimen that does not require prostatic massage for collection. Choice D is incorrect as it suggests collecting a routine urine specimen, which does not fulfill the HCP's orders for specific cultures.

3. Which of the following is a primary intervention for managing hyperphosphatemia?

• A. Increasing calcium intake
• B. Increasing phosphorus intake
• C. Decreasing calcium intake
• D. Administering phosphate binders

Correct answer: D

Rationale: The correct answer is D, administering phosphate binders. Phosphate binders are a primary intervention for managing hyperphosphatemia as they help by binding phosphorus in the gut, preventing its absorption. Increasing calcium intake (choice A) or phosphorus intake (choice B) would exacerbate hyperphosphatemia. Decreasing calcium intake (choice C) is not a primary intervention for managing high phosphorus levels.

4. The nurse writes a problem of “potential for complication related to ovarian hyperstimulation” for a client who is taking clomiphene (Clomid), an ovarian stimulant. Which intervention should be included in the plan of care?

• A. Instruct the client to delay intercourse until menses
• B. Schedule the client for frequent pelvic sonograms
• C. Explain that the infusion therapy will take 21 days
• D. Discuss that this may cause an ectopic pregnancy

Correct answer: B

Rationale: Frequent pelvic sonograms help monitor for ovarian hyperstimulation, a serious potential side effect of clomiphene. Instructing the client to delay intercourse until menses (choice A) is not directly related to monitoring or managing ovarian hyperstimulation. Explaining the duration of infusion therapy (choice C) is not relevant to the potential complication of ovarian hyperstimulation. Discussing the risk of ectopic pregnancy (choice D) is important but not the most appropriate intervention for managing ovarian hyperstimulation.

5. What is the primary goal of care for a client diagnosed with sickle cell anemia?

• A. The client will call the healthcare provider if feeling ill.
• B. The client will be compliant with the medical regimen.
• C. The client will live as normal a life as possible.
• D. The client will verbalize understanding of treatments.

Correct answer: C

Rationale: The correct answer is C: 'The client will live as normal a life as possible.' For a client with sickle cell anemia, the primary goal of care is to promote a good quality of life by managing symptoms, preventing crises, and enhancing overall well-being. Option A is incorrect as it focuses on a specific action rather than the overall goal of care. Option B is important but not the primary goal; compliance is a means to achieve better health outcomes. Option D is also important but does not address the holistic approach of helping the client maintain a normal lifestyle despite their condition.

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