Nursing Elites

1. A healthcare provider is caring for a client who has a leg fracture and reports severe pain. Which of the following actions should the healthcare provider take first?

• A. Administer pain medication
• B. Reposition the client's leg
• C. Elevate the client's leg
• D. Check the client's neurovascular status

Correct answer: D

Rationale: Checking the client's neurovascular status is the priority when caring for a client with severe pain after a leg fracture. This assessment is crucial to identify any signs of vascular compromise or nerve damage, such as compartment syndrome. Administering pain medication can help alleviate the pain but should only be done after ensuring the client's neurovascular status is stable. Repositioning or elevating the leg may worsen the condition if there are underlying vascular issues, making these options lower in priority than assessing neurovascular status.

2. A healthcare provider is reviewing the medical record of a client who is scheduled for an abdominal paracentesis. Which of the following actions should the healthcare provider take to prepare the client for this procedure?

• A. Assist the client to void
• B. Instruct the client to hold their breath
• C. Place the client in a lateral recumbent position
• D. Prepare to administer a sedative

Correct answer: A

Rationale: Assisting the client to void before a paracentesis is essential to reduce the risk of bladder injury during the procedure. Voiding helps empty the bladder, preventing accidental puncture during the insertion of the needle. Instructing the client to hold their breath is incorrect and can increase the risk of complications. Placing the client in a lateral recumbent position is not directly related to bladder safety during a paracentesis. Preparing to administer a sedative is not a standard preparation for this procedure and is not aimed at preventing bladder injury.

3. A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should monitor for which of the following findings as a sign of hypocalcemia?

• A. Nausea
• B. Tingling in the fingers
• C. Numbness in the toes
• D. Sweating

Correct answer: B

Rationale: Tingling in the fingers is a classic sign of hypocalcemia. Following a thyroidectomy, hypocalcemia can occur due to damage to the parathyroid glands, which regulate calcium levels in the body. Nausea, numbness in the toes, and sweating are not specific signs of hypocalcemia. Numbness and tingling usually start in the hands and feet due to their increased nerve sensitivity to low calcium levels.

4. A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home?

• A. Family members who smoke should be at least 10 ft away from the client when oxygen is in use
• B. Nail polish should not be used near a client who is receiving oxygen
• C. A 'No Smoking' sign should be placed on the front door
• D. Cotton bedding and clothing should be replaced with items made from wool

Correct answer: C

Rationale: The correct answer is C. Placing a 'No Smoking' sign on the front door is crucial for fire safety when using oxygen at home. Choice A is incorrect as family members who smoke should not be around the client when oxygen is in use, not just at a distance. Choice B is not directly related to oxygen safety. Choice D is also irrelevant as the type of bedding and clothing material does not impact oxygen safety.

5. A nurse is reviewing the medical record of a client who is taking enalapril for hypertension. Which of the following findings should the nurse report to the provider?

• A. Blood pressure of 150/80 mm Hg
• B. Swelling in the legs
• C. Persistent cough
• D. Heart rate of 72 beats per minute

Correct answer: C

Rationale: The correct answer is C: Persistent cough. Enalapril is known to cause a persistent dry cough as a side effect. This adverse reaction is due to the accumulation of bradykinin in the lungs, leading to irritation and cough. The nurse should report this symptom to the provider for further evaluation and possible medication adjustment. Choices A, B, and D are not directly associated with enalapril use. While a blood pressure of 150/80 mm Hg is elevated and should be monitored, it is not a direct side effect of enalapril. Swelling in the legs and a heart rate of 72 beats per minute are also not typically related to enalapril use and should be assessed but are not the priority findings to report in this scenario.

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