Nokea
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should Nurse Hans recognize as an adverse drug effect?
- A. Dysuria
- B. Leg cramps
- C. Tachycardia
- D. Blurred vision
Correct Answer: C
Rationale: Tachycardia is a potential adverse effect of levothyroxine, indicating overmedication. Dysuria (painful urination) is not typically associated with levothyroxine. Leg cramps are not a common adverse effect of levothyroxine. Blurred vision is not a typical adverse effect of levothyroxine; instead, it may be a sign of other eye-related conditions or medication side effects.
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A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse the hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
- A. Phentolamine (Regitine)
- B. Methyldopa (Aldomet)
- C. Mannitol (Osmitrol)
- D. Felodipine (Plendil)
Correct Answer: A
Rationale: In a hypertensive crisis due to pheochromocytoma, the appropriate medication to administer is Phentolamine (Regitine), an alpha-adrenergic blocker. Phentolamine acts quickly to block the effects of excess catecholamines that are released in pheochromocytoma, helping to rapidly lower blood pressure. Methyldopa (Aldomet) is an alpha-2 adrenergic agonist used for chronic hypertension, not for acute crises like pheochromocytoma. Mannitol (Osmitrol) is an osmotic diuretic used to reduce intracranial pressure and treat cerebral edema, not indicated for hypertensive crises. Felodipine (Plendil) is a calcium channel blocker used for chronic management of hypertension, not for acute hypertensive crises like those seen in pheochromocytoma.
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.'
Effective leaders must communicate a vision for the future. Which of the following is the best method for communicating a vision for the future?
- A. Involve others in creating the vision and connect daily work tasks to the vision.
- B. Encourage staff nurses to openly discuss practice and possible improvements.
- C. Critically analyze and discuss advances in practice with other nurses on staff.
- D. Actively listen to the recommendations of others.
Correct Answer: A
Rationale: The best method for communicating a vision for the future is to involve others in creating the vision and connect daily work tasks to the vision. This approach fosters ownership and commitment among team members, as they feel part of the vision-building process and understand how their daily tasks contribute to achieving that vision. Choice B, encouraging staff nurses to openly discuss practice and possible improvements, is important for fostering communication but doesn't directly address creating and communicating a vision. Choice C, critically analyzing and discussing advances in practice with other nurses, focuses on professional development and knowledge sharing rather than specifically communicating a future vision. Choice D, actively listening to recommendations, is valuable for gathering input but may not be sufficient on its own for effectively communicating a future vision.
Which instruction about insulin administration should Nurse Kate give to a client?
- A. Always follow the same order when drawing up different insulins into the syringe.
- B. Shake the vials before withdrawing the insulin.
- C. Store unopened vials of insulin in the refrigerator at recommended temperatures.
- D. Discard the intermediate-acting insulin if it appears cloudy.
Correct Answer: A
Rationale: The correct answer is A. Consistently following the same order when drawing up different insulins helps to prevent medication errors. Option B is incorrect because shaking insulin vials could cause bubbles to form, leading to inaccurate dosing. Option C is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness. Option D is incorrect because cloudy appearance in intermediate-acting insulin may indicate the presence of insulin crystals, which can affect its potency, but this does not necessarily mean it should be discarded without consulting a healthcare provider.
A client with type 1 DM is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should prioritize which action?
- A. Administering intravenous fluids.
- B. Administering oral glucose.
- C. Administering a fever-reducing medication.
- D. Administering oxygen therapy.
Correct Answer: A
Rationale: Administering intravenous fluids is the priority in treating DKA for several reasons. DKA is characterized by severe dehydration and electrolyte imbalances due to hyperglycemia. IV fluids help to correct dehydration, restore electrolyte balance, and decrease blood glucose levels. Administering oral glucose (Choice B) would be contraindicated in DKA as the primary issue is high blood glucose levels. Administering a fever-reducing medication (Choice C) is not the priority in managing DKA. Administering oxygen therapy (Choice D) may be necessary in some cases, but correcting dehydration and electrolyte imbalances take precedence in the management of DKA.