Nursing Elites

1. A client is receiving dexamethasone (Decadron). What symptoms should the nurse recognize as Cushingoid side effects?

• A. Moon face, slow wound healing, muscle wasting, sodium and water retention
• B. Tachycardia, hypertension, weight loss, heat intolerance, nervousness, restlessness, tremor
• C. Bradycardia, weight gain, cold intolerance, myxedema facies and periorbital edema
• D. Hyperpigmentation, hyponatremia, hyperkalemia, dehydration, hypotension

Correct answer: A

Rationale: Cushingoid side effects are characteristic of excess corticosteroid use, such as dexamethasone. These include moon face (rounding of the face), slow wound healing, muscle wasting, and sodium and water retention. Options B, C, and D describe symptoms that are not typically associated with Cushingoid side effects. Tachycardia, hypertension, weight loss, heat intolerance, nervousness, restlessness, tremor (Option B) are not typical of Cushingoid effects, while bradycardia, weight gain, cold intolerance, myxedema facies, and periorbital edema (Option C) are more indicative of hypothyroidism. Hyperpigmentation, hyponatremia, hyperkalemia, dehydration, and hypotension (Option D) are not classical features of Cushingoid side effects.

2. A client has a prescription for a Transcutaneous Electrical Nerve Stimulator (TENS) unit for pain management during the postoperative period following a Lumbar Laminectomy. What information should the nurse reinforce about the action of this adjuvant pain modality?

• A. Mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain
• B. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus
• C. An infusion of medication in the spinal canal will block pain perception
• D. The discharge of electricity will distract the client's focus on the pain

Correct answer: A

Rationale: The correct answer is A. TENS units work by delivering small electrical impulses through the skin. These impulses are thought to close the 'gates of nerve conduction,' which can help in managing severe pain. Choice B is incorrect because the dulled pain perception does not occur in the cerebral cortex by the TENS unit. Choice C is incorrect as it describes a different method of pain management involving medication in the spinal canal. Choice D is incorrect because TENS does not work by distracting the client's focus on pain, but rather by altering pain perception through electrical impulses.

3. A healthcare provider is conducting a health education session about the prevention of type 2 diabetes. What lifestyle modification should be emphasized?

• A. Increasing physical activity
• B. Reducing dietary sugar intake
• C. Regular health screenings
• D. All of the above

Correct answer: D

Rationale: To effectively prevent type 2 diabetes, individuals should focus on a combination of lifestyle modifications. Increasing physical activity helps maintain a healthy weight and improves insulin sensitivity. Reducing dietary sugar intake can lower the risk of developing diabetes by managing blood sugar levels. Regular health screenings are crucial for early detection and timely intervention. Emphasizing all these modifications together provides a comprehensive approach to diabetes prevention. Choices A, B, and C are all important components of a healthy lifestyle that can contribute to reducing the risk of type 2 diabetes.

4. A client presents to the emergency department with symptoms of a myocardial infarction. What should the nurse administer immediately under doctor's orders?

• A. Aspirin to prevent further blood clotting
• B. High-flow oxygen
• C. Intravenous fluids
• D. Nitroglycerin

Correct answer: A

Rationale: The correct answer is A: Aspirin to prevent further blood clotting. Administering aspirin is crucial in the immediate management of a myocardial infarction as it helps prevent further blood clot formation, which is a key component in the treatment and prevention of myocardial infarction. Oxygen therapy (Choice B) is often provided, but aspirin takes precedence due to its role in reducing clot formation. Intravenous fluids (Choice C) may be needed but are not the immediate priority in this situation. Nitroglycerin (Choice D) is commonly used for chest pain relief in myocardial infarction but is not the first medication to be administered in this scenario.

5. The nurse is caring for a client postoperatively following a thyroidectomy. Which assessment finding should be reported to the healthcare provider immediately?

• A. Hoarseness of the voice.
• B. Slight swelling at the incision site.
• C. Tingling around the mouth.
• D. Mild fever.

Correct answer: C

Rationale: Tingling around the mouth should be reported to the healthcare provider immediately as it may indicate hypocalcemia, a potential complication after thyroidectomy. Hoarseness of the voice is common postoperatively due to surgical manipulation, slight swelling at the incision site is a normal response, and a mild fever can be expected after surgery. However, tingling around the mouth suggests a potential calcium imbalance, which requires prompt attention to prevent serious complications.

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