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. The nurse is caring for a client with cirrhosis of the liver. Which clinical finding is most concerning?

• A. Jaundice.
• B. Ascites.
• C. Spider angiomas.
• D. Asterixis.

Correct answer: D

Rationale: The correct answer is D, Asterixis. Asterixis, also known as liver flap, is a sign of hepatic encephalopathy, a severe complication of liver disease that necessitates immediate attention. While jaundice (choice A), ascites (choice B), and spider angiomas (choice C) are common clinical findings in cirrhosis, asterixis is the most concerning due to its association with hepatic encephalopathy, which can lead to altered mental status and even coma. Jaundice, ascites, and spider angiomas are also important signs in cirrhosis, but asterixis indicates a more critical condition requiring urgent intervention.

3. What are the final factors that contribute to blood pressure? (Select all that apply)

• A. Heart rate
• B. Stroke volume
• C. Peripheral resistance
• D. Neuroendocrine hormones

Correct answer: D

Rationale: Neuroendocrine hormones play a crucial role in regulating blood pressure by influencing factors like fluid balance, blood volume, and vessel constriction. While heart rate, stroke volume, and peripheral resistance are important factors affecting blood pressure, the final parameters that directly produce blood pressure are influenced by neuroendocrine hormones. Therefore, choice D is the correct answer. Choices A, B, and C are involved in the regulation of blood pressure but are not the final parameters that directly produce it.

4. The nurse is assessing a client with hyperkalemia. Which finding is consistent with this electrolyte imbalance?

• A. Muscle weakness
• B. Decreased deep tendon reflexes
• C. Constipation
• D. Hypotension

Correct answer: A

Rationale: Muscle weakness is a common finding in clients with hyperkalemia. Hyperkalemia can lead to muscle weakness due to the effect of high potassium levels on muscle function. Decreased deep tendon reflexes (Choice B) are not typically associated with hyperkalemia; instead, hyperreflexia or increased reflexes may be observed. Constipation (Choice C) is not a common symptom of hyperkalemia. Hypotension (Choice D) is also not a typical finding in hyperkalemia; instead, hypertension or normal blood pressure may be present.

5. A postoperative client complains of sudden shortness of breath. What should the nurse do first?

• A. Administer oxygen
• B. Call the healthcare provider
• C. Prepare for chest x-ray
• D. Assess the client's lung sounds

Correct answer: D

Rationale: Assessing the client's lung sounds is the most appropriate initial action when a postoperative client complains of sudden shortness of breath. This step helps the nurse evaluate the respiratory status and detect abnormalities such as decreased breath sounds or crackles, which could indicate a serious condition like a pulmonary embolism. Administering oxygen (Choice A) may be necessary but should come after assessing the lung sounds to ensure the appropriate intervention. Calling the healthcare provider (Choice B) or preparing for a chest x-ray (Choice C) can be important subsequent actions based on the findings from the lung sound assessment, but they are not the first priority in this situation.

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