Nursing Elites

1. A client with a diagnosis of hypothyroidism is prescribed levothyroxine (Synthroid). Which symptom should prompt the nurse to notify the healthcare provider?

• A. Weight gain.
• B. Bradycardia.
• C. Nervousness and tremors.
• D. Fatigue.

Correct answer: C

Rationale: The correct answer is C: 'Nervousness and tremors.' In a client with hypothyroidism prescribed levothyroxine, the development of nervousness and tremors may indicate hyperthyroidism, which can result from excessive dosing of levothyroxine. Therefore, the nurse should promptly notify the healthcare provider to adjust the medication dosage. Choices A, B, and D are incorrect because weight gain, bradycardia, and fatigue are more commonly associated with hypothyroidism itself, indicating that the levothyroxine therapy may not be effective enough, rather than being signs of excessive dosing.

2. A client's daughter phones the charge nurse to report that the night nurse did not provide good care for her mother. What response should the nurse make?

• A. Explain that all staff are doing their best
• B. Ask for a description of what happened during the night
• C. Tell the daughter to talk to the unit's nurse manager
• D. Reassure the daughter that the mother will get better care

Correct answer: B

Rationale: The correct response for the nurse in this situation is to ask for a description of what happened during the night. This allows the nurse to gather specific information about the care provided and address the complaint appropriately. Choice A is incorrect because dismissing the concern by stating that all staff are doing their best does not address the specific complaint. Choice C is not the best immediate response as the charge nurse should first gather information before escalating the issue to the nurse manager. Choice D is incorrect as it focuses on reassurance without addressing the reported issue.

3. Prior to administering morphine sulfate (Morphine), the nurse takes the client's vital signs. Based on which finding should the nurse withhold administration of the medication until the charge nurse is notified?

• A. Temperature of 100.8°F
• B. A pulse rate of 150 beats per minute
• C. A respiratory rate of 10 breaths per minute
• D. A blood pressure of 180/110

Correct answer: C

Rationale: The correct answer is C because a low respiratory rate is a critical concern when administering opioids like morphine, as they can suppress breathing. A high pulse rate (choice B) and high blood pressure (choice D) are not immediate contraindications for administering morphine. A slightly elevated temperature (choice A) may not necessarily require withholding morphine.

4. A client with a chronic illness expresses frustration over their condition. What is the nurse's best response to support the client?

• A. Encourage joining a support group for emotional support
• B. Discuss the possibility of a cure in the future
• C. Suggest focusing on positive aspects of their life
• D. Validate their feelings and listen to their concerns

Correct answer: D

Rationale: The best response for the nurse to support a client expressing frustration over their chronic illness is to validate their feelings and listen to their concerns (Option D). This approach helps acknowledge the client's emotions, demonstrates empathy, and establishes a therapeutic relationship. By validating the client's feelings and actively listening to their concerns, the nurse offers a supportive environment for the client to express their frustrations. Choices A, B, and C are not the best responses in this situation. While joining a support group, discussing a cure, or focusing on positive aspects can be beneficial interventions, the immediate priority is to validate the client's feelings and provide a space for them to express their frustrations.

5. A client is admitted with Atrial Fibrillation and is administered amiodarone (Cordarone). What therapeutic response should the nurse anticipate?

• A. Conversion of irregular heart rate to regular heart rhythm
• B. Pulse oximetry readings within normal range during activity
• C. Peripheral pulse points with adequate capillary refill
• D. Increase in exercise tolerance without shortness of breath

Correct answer: A

Rationale: The correct answer is A: Conversion of irregular heart rate to regular heart rhythm. Amiodarone is a medication commonly used to restore and maintain normal heart rhythm in clients with atrial fibrillation. It works by slowing down the electrical signals in the heart, helping to regulate the heartbeat. Choices B, C, and D are incorrect because they do not directly relate to the therapeutic response expected from administering amiodarone in a client with atrial fibrillation. Pulse oximetry readings, peripheral pulses, capillary refill, and exercise tolerance are important assessments but are not the primary therapeutic goal of using amiodarone in this situation.

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