Nursing Elites

1. A nurse is assessing a client who has diabetes mellitus and is experiencing hyperglycemia. Which of the following findings should the nurse expect?

• A. Polyuria
• B. Hypoglycemia
• C. Diaphoresis
• D. Tachycardia

Correct answer: A

Rationale: Polyuria is the excessive production of urine and is a common finding in clients with hyperglycemia due to increased glucose levels. High blood sugar levels lead to the body trying to eliminate the excess glucose through urine, resulting in increased urination. Hypoglycemia (choice B) is low blood sugar and is not typically associated with hyperglycemia. Diaphoresis (choice C) is excessive sweating and is not a direct symptom of hyperglycemia. Tachycardia (choice D) is increased heart rate and is not a primary finding in hyperglycemia.

2. What is the most important intervention for a patient with suspected DVT?

• A. Administer anticoagulants
• B. Monitor oxygen levels
• C. Apply compression stockings
• D. Encourage ambulation

Correct answer: A

Rationale: The correct answer is to administer anticoagulants. Administering anticoagulants is crucial in the management of deep vein thrombosis (DVT) as it helps prevent the clot from growing larger or dislodging, potentially causing a life-threatening pulmonary embolism. While monitoring oxygen levels, applying compression stockings, and encouraging ambulation are important aspects of DVT management, administering anticoagulants is the most critical intervention to prevent further complications.

3. A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings should the nurse report to the provider?

• A. Serum calcium level of 8 mg/dL.
• B. Urine output of 60 mL/hr.
• C. Heart rate of 110/min.
• D. Temperature of 37.5°C (99.5°F).

Correct answer: C

Rationale: The correct answer is C. A heart rate of 110/min is elevated and may indicate hypocalcemia, a potential complication following a thyroidectomy. Elevated heart rate can be a sign of hypocalcemia due to the close relationship between calcium levels and cardiac function. Option A, serum calcium level of 8 mg/dL, is within the normal range (8.5-10.5 mg/dL) and would not be a cause for concern post-thyroidectomy. Option B, urine output of 60 mL/hr, is within the normal range for urine output and not typically a priority finding post-thyroidectomy. Option D, a temperature of 37.5°C (99.5°F), is slightly elevated but not a critical finding post-thyroidectomy unless accompanied by other symptoms.

4. A client is being discharged with a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take this medication with meals to avoid stomach upset.
• B. Take this medication at the same time every day.
• C. Notify your provider if you experience chest pain or palpitations.
• D. Take this medication with antacids to reduce indigestion.

Correct answer: B

Rationale: The correct answer is B: 'Take this medication at the same time every day.' It is crucial to take levothyroxine at the same time each day to maintain consistent thyroid hormone levels. Choice A is incorrect because levothyroxine should be taken on an empty stomach, usually in the morning. Choice C is important but not specific to the administration of levothyroxine. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.

5. A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will avoid aspirin while taking this medication.
• B. I will increase my intake of green leafy vegetables.
• C. I will take this medication with an antacid.
• D. I should expect mild bruising around my elbows.

Correct answer: A

Rationale: The correct answer is A: "I will avoid aspirin while taking this medication." Clients taking warfarin should avoid aspirin due to the increased risk of bleeding. Choice B is incorrect because increasing the intake of green leafy vegetables high in Vitamin K can interfere with the effects of warfarin. Choice C is incorrect because warfarin should not be taken with antacids as they can decrease its absorption. Choice D is incorrect because mild bruising is a common side effect of warfarin due to its anticoagulant properties.

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