Nursing Elites

1. A nurse has provided education to a client regarding prescribed levothyroxine sodium. Which of the following client statements demonstrates understanding of medication administration?

• A. I should take the medication in the morning to prevent insomnia.
• B. I can take the medication at night before bed.
• C. I will stop the medication if I start to feel better.
• D. I will take the medication only when I feel symptoms.

Correct answer: A

Rationale: The correct answer is A. Levothyroxine should be taken in the morning on an empty stomach to prevent insomnia and ensure proper absorption of the medication. Choice B is incorrect because taking levothyroxine at night may interfere with sleep and absorption. Choice C is incorrect as stopping the medication without consulting the healthcare provider can lead to negative health outcomes. Choice D is incorrect because levothyroxine is a daily medication that should be taken consistently, not just when symptoms are present.

2. A nurse is caring for a newborn diagnosed with necrotizing enterocolitis (NEC). Which of the following interventions should the nurse expect to implement?

• A. Withhold oral feedings
• B. Measure abdominal girth
• C. Position the newborn supine
• D. Apply cold compresses to the abdomen

Correct answer: B

Rationale: Measuring abdominal girth is crucial in monitoring for signs of abdominal distension, which is a key indicator of worsening necrotizing enterocolitis (NEC). It helps in assessing the progression of the condition. Positioning the newborn supine, as in choice C, can help relieve pressure on the abdomen but does not directly monitor the condition. Applying cold compresses, as in choice D, is not recommended for NEC as it can constrict blood vessels and potentially worsen the condition. Withholding oral feedings, as in choice A, is also important to rest the bowel and prevent further complications, but measuring abdominal girth is more directly related to monitoring the progression of NEC.

3. A healthcare professional is assessing a client for signs of dehydration. Which of the following findings should the healthcare professional look for?

• A. Edema
• B. Dry mucous membranes
• C. Weight gain
• D. Increased urination

Correct answer: B

Rationale: Dry mucous membranes are a classic sign of dehydration. In dehydration, the body loses more water than it takes in, leading to dryness of mucous membranes like the mouth and throat. Edema (choice A) is swelling caused by excess fluid trapped in the body's tissues, which is not a typical sign of dehydration. Weight gain (choice C) is also not a common sign of dehydration; in fact, dehydration usually leads to weight loss. Increased urination (choice D) is more indicative of conditions like diabetes or diuretic use, not dehydration.

4. A nurse is assessing a pregnant client at 32 weeks gestation and notes that the client has gained 5 pounds in one week. Which of the following conditions should the nurse suspect?

• A. Preeclampsia
• B. Gestational diabetes
• C. Anemia
• D. Placenta previa

Correct answer: A

Rationale: The correct answer is A: Preeclampsia. Rapid weight gain, especially in the third trimester, can be a sign of preeclampsia, a condition characterized by hypertension, edema, and proteinuria. This requires immediate medical attention. Choice B, Gestational diabetes, is incorrect because rapid weight gain is not a typical symptom of gestational diabetes. Choice C, Anemia, is incorrect as weight gain is not a common sign of anemia in pregnancy. Choice D, Placenta previa, is also incorrect because weight gain is not a typical symptom of this condition, which involves the placenta partially or completely covering the cervix.

5. A nurse is reviewing a prescription for doxazosin with a client. Which instruction should the nurse include?

• A. Decrease caloric intake to reduce weight gain
• B. Increase dietary fiber to prevent constipation
• C. Rise slowly when sitting up
• D. Take this medication each morning

Correct answer: C

Rationale: The correct answer is C: 'Rise slowly when sitting up.' Doxazosin can cause orthostatic hypotension, a sudden drop in blood pressure when standing up, leading to dizziness or fainting. Instructing the client to rise slowly helps prevent this adverse effect. Choices A, B, and D are incorrect. A decrease in caloric intake to reduce weight gain, an increase in dietary fiber to prevent constipation, and taking the medication each morning are not specific instructions related to managing the side effects of doxazosin.

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