Nursing Elites

1. A 60-year-old woman presents with pruritus, jaundice, and xanthomas. Laboratory tests reveal elevated cholesterol and alkaline phosphatase levels. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: The combination of pruritus, jaundice, and xanthomas, along with elevated cholesterol and alkaline phosphatase levels, is classic for primary biliary cirrhosis. Pruritus is often the initial symptom, followed by jaundice due to cholestasis. Xanthomas, elevated cholesterol, and alkaline phosphatase levels are also common findings in primary biliary cirrhosis. Primary sclerosing cholangitis and pancreatic cancer may present with similar symptoms but are less likely in this clinical context.

2. A client with a history of chronic obstructive pulmonary disease (COPD) presents with increasing shortness of breath. Which assessment finding is most important for the nurse to report to the healthcare provider?

• A. Barrel-shaped chest.
• B. Use of accessory muscles to breathe.
• C. Oxygen saturation of 88%.
• D. Respiratory rate of 22 breaths per minute.

Correct answer: C

Rationale: An oxygen saturation of 88% indicates hypoxemia, which is a critical finding in a client with COPD. Hypoxemia can lead to serious complications and may require immediate intervention, such as adjusting oxygen therapy to improve oxygenation levels and prevent further respiratory distress. Monitoring and maintaining adequate oxygen saturation is crucial in managing COPD exacerbations and preventing respiratory failure.

3. A patient with hyperthyroidism is to receive radioactive iodine therapy. What information should the nurse include in the patient teaching plan?

• A. Avoid close contact with pregnant women for one week.
• B. Take iodine supplement daily.
• C. Restrict fluid intake to 1 liter per day.
• D. Use disposable utensils for all meals.

Correct answer: A

Rationale: The correct answer is to avoid close contact with pregnant women for one week. This precaution is essential to prevent radiation exposure to vulnerable populations. Pregnant women and small children are more sensitive to radiation, making it crucial for patients undergoing radioactive iodine therapy to avoid close contact with them for a specified period. Choices B, C, and D are incorrect because taking iodine supplements daily is not necessary for patients receiving radioactive iodine therapy. Restricting fluid intake to 1 liter per day is not a standard recommendation for radioactive iodine therapy. Using disposable utensils for all meals is not a specific precaution related to radioactive iodine therapy.

4. The charge nurse observes that a client with a nasogastric tube on low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What action should the nurse take?

• A. Remove the glass of water and speak to the UAP.
• B. Discuss the incident with the UAP at the end of the day.
• C. Write an incident report and notify the healthcare provider.
• D. Remind the client of the potential for electrolyte imbalance.

Correct answer: A

Rationale: The correct action for the charge nurse to take is to remove the glass of water and speak to the UAP. This ensures immediate correction and education to prevent further issues with the nasogastric tube. Addressing the situation promptly can prevent harm to the client and reinforces the importance of following proper protocols.

5. What instruction should a patient with a history of hypertension be provided when being discharged with a prescription for a thiazide diuretic?

• A. Avoid foods high in potassium.
• B. Take the medication at bedtime.
• C. Monitor weight daily.
• D. Limit fluid intake to 1 liter per day.

Correct answer: C

Rationale: The correct instruction for a patient with a history of hypertension being discharged with a prescription for a thiazide diuretic is to monitor weight daily. This is important because thiazide diuretics can cause fluid imbalances, and monitoring weight daily can help detect significant changes early. Choice A, avoiding foods high in potassium, is not directly related to thiazide diuretics. Choice B, taking the medication at bedtime, may vary depending on the specific medication but is not a universal instruction. Choice D, limiting fluid intake to 1 liter per day, is not appropriate as adequate hydration is important to prevent complications like hypokalemia.

Similar Questions