Nursing Elites

1. A healthcare professional is assessing a client who has a new prescription for levothyroxine. Which of the following findings should the healthcare professional report to the provider?

• A. Weight gain
• B. Increased heart rate
• C. Heat intolerance
• D. Elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: Heat intolerance. Heat intolerance is a concerning sign of levothyroxine toxicity and should be reported to the provider promptly. Levothyroxine is a medication used to treat hypothyroidism by supplementing the body's thyroid hormones. When a client experiences heat intolerance, it can indicate that the dose of levothyroxine is too high, leading to hyperthyroidism symptoms. Weight gain, increased heart rate, and elevated blood pressure are not typically associated with levothyroxine toxicity; instead, they are more commonly seen in conditions like hypothyroidism.

2. The healthcare provider is monitoring a client with chronic stable angina. Which symptom would indicate that the client's condition is worsening?

• A. Increased shortness of breath with exertion
• B. Improved tolerance to activity
• C. Decreased frequency of chest pain
• D. Stable blood pressure readings

Correct answer: A

Rationale: Increased shortness of breath with exertion is a concerning symptom in a client with chronic stable angina as it may indicate inadequate oxygen supply to the heart muscle, suggesting a worsening condition. This could be a sign of reduced blood flow to the heart, leading to increased work for the heart during exertion, resulting in increased shortness of breath. Choice B, improved tolerance to activity, is incorrect as it would indicate a positive response to treatment. Choice C, decreased frequency of chest pain, is incorrect as it would also suggest an improvement in the client's condition. Choice D, stable blood pressure readings, are not indicative of a worsening condition in chronic stable angina.

3. A healthcare professional is assessing a client who has been taking lithium carbonate for bipolar disorder. Which of the following findings should the professional report to the provider?

• A. Increased urination
• B. Tremors
• C. Weight gain
• D. Blurred vision

Correct answer: B

Rationale: Tremors are a concerning sign of lithium toxicity that indicate a potential overdose. Tremors can progress to more severe symptoms if not addressed promptly. Reporting tremors promptly allows the provider to assess the client's lithium levels, adjust the dosage, or provide appropriate interventions to prevent further complications. Increased urination, weight gain, and blurred vision are potential side effects of lithium but are not indicative of toxicity or overdose. While they should still be monitored, they are not as urgent as tremors in the context of lithium therapy.

4. A healthcare provider is assisting in the care of a client who is having central venous pressure (CVP) measurements taken. The healthcare provider should assist by placing the bed in which position for the reading?

• A. Flat
• B. Semi-Fowler's
• C. Trendelenburg
• D. Reverse Trendelenburg

Correct answer: A

Rationale: Central venous pressure (CVP) measurements are most accurate when the client is lying flat, as this allows for a consistent baseline. Placing the bed flat ensures that the hydrostatic pressure within the vena cava is not affected by the client's position, providing a more precise reading. Choice B (Semi-Fowler's) elevates the head of the bed at a 30-45 degree angle, which could affect the accuracy of CVP readings. Choices C (Trendelenburg) and D (Reverse Trendelenburg) involve extreme positions that would not be suitable for obtaining accurate CVP measurements.

5. A client with a history of coronary artery disease (CAD) is prescribed atorvastatin (Lipitor). The nurse should teach the client about which common side effect of this medication?

• A. Dry mouth
• B. Muscle pain
• C. Drowsiness
• D. Diarrhea

Correct answer: B

Rationale: Muscle pain is a common side effect of statins like atorvastatin. It is important for the nurse to educate the client about this potential side effect, as it can indicate a serious condition called rhabdomyolysis, which requires immediate medical attention. Dry mouth, drowsiness, and diarrhea are not typically associated with atorvastatin use.

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