Nokea
A client with hyperaldosteronism is at risk for which of the following electrolyte imbalances?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypokalemia
- D. Hypercalcemia
Correct Answer: C
Rationale: In hyperaldosteronism, there is an excessive secretion of aldosterone, a hormone that promotes potassium excretion in the kidneys. This leads to low potassium levels in the blood, known as hypokalemia. Therefore, the correct answer is hypokalemia (Choice C). Hyperkalemia (Choice A) is the opposite condition, where there is high potassium levels in the blood and is not typically associated with hyperaldosteronism. Hyponatremia (Choice B) is a low sodium level, which is not directly related to aldosterone function. Hypercalcemia (Choice D) is an elevated calcium level and is not typically a direct result of hyperaldosteronism.
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During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?
- A. At least once a week
- B. At least three times a week
- C. At least five times a week
- D. Every day
Correct Answer: C
Rationale: Exercising at least five times a week is recommended to meet the goals of planned exercise for diabetic clients. This frequency helps in managing blood sugar levels effectively and improving overall health. Exercising once a week (Choice A) may not provide sufficient benefits or consistency required for diabetic clients. Exercising three times a week (Choice B) is better but may still fall short of the recommended frequency for optimal outcomes. Exercising every day (Choice D) may lead to burnout or overtraining if not properly balanced with rest days, which could be counterproductive for diabetic clients.
A female client with physical findings suggestive of a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, necessitating a transsphenoidal hypophysectomy. The evening before the surgery, Nurse Jacob reviews preoperative and postoperative instructions provided to the client earlier. Which postoperative instruction should the nurse emphasize?
- A. You must lie flat for 24 hours after surgery.
- B. You must avoid coughing, sneezing, and blowing your nose.
- C. You must restrict your fluid intake.
- D. You must report ringing in your ears immediately.
Correct Answer: B
Rationale: Following a transsphenoidal hypophysectomy, it is crucial to avoid activities such as coughing, sneezing, and blowing the nose to prevent an increase in intracranial pressure or the risk of cerebrospinal fluid leakage. Coughing, sneezing, or nose blowing can strain the surgical site, potentially leading to complications. Lying flat for 24 hours is not typically required after this surgery. Fluid intake should be encouraged to prevent dehydration. Ringing in the ears is not a common complication associated with this type of surgery.
The healthcare provider is monitoring a client with diabetic ketoacidosis (DKA). Which of the following laboratory findings would be expected?
- A. Decreased blood glucose levels
- B. Decreased urine ketones
- C. Increased serum bicarbonate
- D. Increased anion gap
Correct Answer: D
Rationale: In diabetic ketoacidosis (DKA), there is an excess of ketone bodies produced due to the breakdown of fatty acids for energy, leading to metabolic acidosis. An increased anion gap is a characteristic laboratory finding in DKA. The increased anion gap is a result of the accumulation of ketoacids and lactic acid in the blood, contributing to metabolic acidosis. Therefore, the correct answer is an increased anion gap. Choices A, B, and C are incorrect because in DKA, blood glucose levels are typically elevated, urine ketones are increased due to the breakdown of fatty acids, and serum bicarbonate is usually decreased as it is consumed in an attempt to buffer the acidosis.
The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?
- A. Increase your sodium intake during periods of stress.
- B. Avoid all types of exercise.
- C. Decrease your fluid intake to prevent fluid overload.
- D. Stop corticosteroid therapy once symptoms improve.
Correct Answer: A
Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.
Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:
- A. 1130 and 1330.
- B. 1330 and 1930.
- C. 1530 and 2130.
- D. 1730 and 2330.
Correct Answer: C
Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.