Nursing Elites

1. A client with heart failure is experiencing shortness of breath and swelling in the legs. What is the nurse's priority intervention?

• A. Administer prescribed diuretics
• B. Place the client in a supine position
• C. Restrict fluid intake immediately
• D. Increase the client's sodium intake

Correct answer: A

Rationale: The correct answer is A: Administer prescribed diuretics. Diuretics are prescribed to reduce fluid overload in clients with heart failure. By promoting urine output, diuretics help alleviate symptoms like shortness of breath and swelling. While placing the client in a supine position can help with breathing and fluid redistribution, administering diuretics takes precedence as it directly addresses fluid overload. Restricting fluid intake immediately may be necessary in some cases, but the immediate priority is to administer diuretics. Increasing the client's sodium intake would worsen fluid retention and is contraindicated in heart failure.

2. A pregnant client complains of heartburn. What instruction should the nurse provide?

• A. Eat spicy food to help digestion.
• B. Eat small meals throughout the day to avoid a full stomach.
• C. Drink carbonated beverages to ease digestion.
• D. Avoid drinking fluids after meals.

Correct answer: B

Rationale: The correct instruction for a pregnant client experiencing heartburn is to eat small meals throughout the day to avoid a full stomach. This helps prevent the stomach from becoming overly full, reducing the likelihood of heartburn during pregnancy. Choices A, C, and D are incorrect. Eating spicy food can exacerbate heartburn, carbonated beverages may trigger heartburn due to gas, and avoiding fluids after meals does not directly address the issue of heartburn.

3. A client with hypothyroidism is prescribed levothyroxine. What symptom indicates that the dosage may need adjustment?

• A. Increased appetite and weight gain.
• B. Increased sensitivity to cold and dry skin.
• C. Increased heart palpitations and sweating.
• D. Increased shortness of breath and rapid heart rate.

Correct answer: B

Rationale: Increased sensitivity to cold and dry skin may indicate that the dosage of levothyroxine is too low, requiring adjustment. This symptom is typical of hypothyroidism when the body's metabolism slows down, leading to feeling cold and having dry skin. Choices A, C, and D present symptoms more commonly associated with hyperthyroidism, where the body is in a state of overactivity, leading to weight loss, increased heart rate, and sweating. Therefore, these symptoms would not indicate the need for dosage adjustment in a client with hypothyroidism.

4. A client with asthma is prescribed an inhaled corticosteroid. What teaching should the nurse provide?

• A. Rinse the mouth with water after using the inhaler.
• B. Take the medication only during asthma attacks.
• C. Avoid using the inhaler before exercise.
• D. Clean the inhaler with hot water after each use.

Correct answer: A

Rationale: The correct teaching the nurse should provide to a client prescribed an inhaled corticosteroid is to rinse the mouth with water after using the inhaler. This helps prevent oral fungal infections, a common side effect of inhaled corticosteroids. Choice B is incorrect because inhaled corticosteroids are usually used regularly, not just during asthma attacks. Choice C is incorrect as using the inhaler before exercise can actually help prevent exercise-induced bronchospasm. Choice D is incorrect because cleaning the inhaler with hot water after each use is not necessary and may damage the device.

5. Prolonged exposure to high concentrations of supplemental oxygen over several days can cause which pathophysiological effect?

• A. Reduced cardiac output
• B. Disrupted surfactant production
• C. Hyperactivity of alveoli
• D. Increased oxygen carrying capacity

Correct answer: B

Rationale: Corrected Rationale: Prolonged exposure to high oxygen concentrations can disrupt the production of surfactant in the lungs, leading to atelectasis and other lung complications. Surfactant is essential for maintaining lung compliance and preventing alveolar collapse. Reduced cardiac output (Choice A) is not directly associated with prolonged oxygen exposure. Hyperactivity of alveoli (Choice C) is not a recognized consequence of high oxygen levels. Increased oxygen carrying capacity (Choice D) is not a pathophysiological effect of prolonged high oxygen exposure.

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