Nokea
The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?
- A. Insulin
- B. Hydrocortisone
- C. Levothyroxine
- D. Methimazole
Correct Answer: B
Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.
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Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
- A. Fluid intake is less than 2,500 ml/day
- B. Urine output measures more than 200 ml/hour
- C. Blood pressure is 90/50 mm Hg
- D. The heart rate is 126 beats/minute
Correct Answer: A
Rationale: The correct outcome indicating effective treatment of diabetes insipidus in a male client is a fluid intake of less than 2,500 ml/day. In diabetes insipidus, excessive urination causes increased fluid intake to compensate for the fluid loss. By effectively managing the condition, the client's fluid intake should decrease. Choices B, C, and D do not directly reflect the effectiveness of treatment for diabetes insipidus. Increased urine output (choice B) may indicate inadequate control of the condition, while low blood pressure (choice C) and a high heart rate (choice D) are not specific indicators of effective treatment for diabetes insipidus.
A healthcare professional is reviewing the medication orders for a client with hypothyroidism. Which of the following medications should the healthcare professional question?
- A. Levothyroxine
- B. Amiodarone
- C. Calcium supplements
- D. Aspirin
Correct Answer: B
Rationale: The correct answer is B: Amiodarone. Amiodarone can affect thyroid function and potentially worsen hypothyroidism, so its use should be carefully considered or questioned in clients with this condition. Levothyroxine (Choice A) is the mainstay therapy for hypothyroidism and should not be questioned in this scenario. Calcium supplements (Choice C) are not typically contraindicated in clients with hypothyroidism and may be needed if there is a deficiency. Aspirin (Choice D) is not directly related to thyroid function and is not a medication that would typically be questioned in a client with hypothyroidism.
A client with syndrome of inappropriate antidiuretic hormone (SIADH) is at risk for which of the following complications?
- A. Hypernatremia
- B. Hyponatremia
- C. Hyperkalemia
- D. Hypercalcemia
Correct Answer: B
Rationale: The correct answer is B: Hyponatremia. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention in the body. This causes dilutional hyponatremia, where the sodium levels in the blood become abnormally low. Option A, Hypernatremia, is incorrect because SIADH does not cause elevated sodium levels. Option C, Hyperkalemia, is incorrect as SIADH does not directly affect potassium levels. Option D, Hypercalcemia, is also incorrect as SIADH does not impact calcium levels.
In a client with hypoparathyroidism, the nurse should expect which laboratory result?
- A. Increased calcium levels
- B. Decreased phosphorus levels
- C. Increased phosphorus levels
- D. Increased potassium levels
Correct Answer: C
Rationale: In hypoparathyroidism, there is a deficiency of parathyroid hormone, leading to decreased calcium levels and increased phosphorus levels. Therefore, the correct answer is 'Increased phosphorus levels' (Choice C). Choice A, 'Increased calcium levels,' is incorrect because hypoparathyroidism is associated with low calcium levels. Choice B, 'Decreased phosphorus levels,' is incorrect as phosphorus levels are typically elevated in hypoparathyroidism. Choice D, 'Increased potassium levels,' is not directly related to hypoparathyroidism and is not an expected laboratory result in this condition.
A good relationship between a leader and a follower enables the follower to 'manage up.' Which of the following describes the best way for a follower to 'manage up'?
- A. Provide feedback to the unit manager when asked for it.
- B. Assist your manager in capitalizing on his or her strengths and weaknesses.
- C. When working with a manager with poor leadership skills, transferring to a different unit is the best option.
- D. Show respect and appreciation for the manager, even when conversing with coworkers.
Correct Answer: B
Rationale: The best way for a follower to 'manage up' is by assisting the manager in capitalizing on his or her strengths and weaknesses. By doing so, the follower helps build a good working relationship with the manager, fostering mutual growth and development. Choice A is not the best option as it only focuses on providing feedback when asked, which may not necessarily contribute to 'managing up.' Choice C is incorrect because transferring to a different unit should not be the first solution when dealing with a manager with poor leadership skills; instead, efforts should be made to improve the current working relationship. Choice D, while important, focuses more on showing respect and appreciation rather than actively helping the manager improve, which is key to 'managing up.'