Nokea
The nurse is planning a staff education program about conditions that increase cortisol levels. Which of the following conditions should the nurse include?
- A. Addison's disease
- B. Congestive heart failure (CHF)
- C. Renal failure
- D. Cushing's disease
Correct Answer: D
Rationale: Cushing's disease increases cortisol due to excess ACTH. Addison's reduces cortisol, and CHF and renal failure do not directly elevate cortisol levels.
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The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an infusion of regular insulin. Which of the following clinical data should be reported to the primary healthcare provider (PHCP) immediately?
- A. Glucose 297 mg/dL, 16.52 mmol/L (70-110 mg/dL, 4.0-11.0 mmol/L)
- B. Potassium 3.2 mEq/L, 3.2 mmol/L (3.5-5 mEq/L, 3.5-5.1 mmol/L)
- C. BUN 24 mg/dL, 8.568 mmol/L (10-20 mg/dL, 2.5 to 6.4 mmol/L)
- D. Hemoglobin A1C 8.9% ( < 7%, 4.8%-6.0%)
Correct Answer: B
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. A level of 3.2 mEq/L is critical and needs immediate reporting to prevent arrhythmias. Glucose, BUN, and HbA1C are monitored but less urgent.
The nurse is caring for a client who has acute pancreatitis. Based on the 11:15 AM vital signs, the nurse should prioritize which action? Click to view the exhibit for additional client information.
- A. Obtain a 12-lead electrocardiogram
- B. Assess the client for pain
- C. Apply oxygen via nasal cannula
- D. Infuse 500 ml 0.9% sodium chloride (normal saline) bolus
Correct Answer: B
Rationale: Acute pancreatitis causes severe pain, a hallmark symptom. Without vital signs data, pain assessment is the priority to guide treatment and comfort, preceding ECG, oxygen, or fluids.
The nurse is attending to a client with recent, significant weight gain. Which of the following diseases decreases the basal metabolic rate?
- A. Cancer
- B. Hypothyroidism
- C. Chronic obstructive pulmonary disease (COPD)
- D. Cardiac failure
Correct Answer: B
Rationale: Hypothyroidism slows metabolism, reducing basal metabolic rate and causing weight gain. Cancer, COPD, and cardiac failure often increase metabolic demand or are unrelated.
The nurse caring for a diabetes mellitus client obtained a scheduled capillary blood glucose. The result indicated 40 mg/dL (2.22 mmol/L) [70-110 mg/dL, 4.0-11.0 mmol/L]. The client reports no symptoms. The initial action of the nurse should be which of the following?
- A. Document the finding in the medical record
- B. Repeat the capillary blood glucose test to validate the result
- C. Administer 15 grams of a quick-acting carbohydrate
- D. Administer 1 mg of glucagon subcutaneously
Correct Answer: B
Rationale: A glucose of 40 mg/dL is critically low, even without symptoms. Repeating the test validates the result, ensuring accuracy before treatment to avoid unnecessary intervention.
The nurse is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should the nurse question?
- A. Furosemide for a client with hyperparathyroidism
- B. Methimazole for a client with hyperthyroidism
- C. Hydrocortisone for a client with diabetes insipidus
- D. Prazosin for a client with pheochromocytoma
Correct Answer: C
Rationale: Hydrocortisone is inappropriate for diabetes insipidus, which requires desmopressin to manage water reabsorption. Furosemide may be used in hyperparathyroidism, methimazole treats hyperthyroidism, and prazosin manages hypertension in pheochromocytoma.