Nursing Elites

1. A nurse is caring for a client with schizophrenia. Which of the following assessment findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Poor problem-solving ability
• D. Preoccupation with somatic disturbances

Correct answer: B

Rationale: In schizophrenia, clients often display an inability to identify common objects due to cognitive impairment. This is known as associative agnosia, where individuals struggle to recognize familiar objects, faces, or sounds. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head trauma or drug overdose. Poor problem-solving ability may be seen in various mental health disorders but is not specific to schizophrenia. Preoccupation with somatic disturbances is more commonly seen in somatic symptom disorders or somatic delusions, not a typical finding in schizophrenia.

2. A client has a new prescription for captopril. Which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. You may experience a persistent dry cough.
• C. Increase your intake of foods high in potassium.
• D. You should avoid eating grapefruit while taking this medication.

Correct answer: B

Rationale: The correct answer is B. A persistent dry cough is a common side effect of captopril, an ACE inhibitor, and should be included in the teaching. Choice A is incorrect because captopril is usually taken on an empty stomach. Choice C is incorrect because captopril can increase potassium levels, so there is no need to further increase potassium intake. Choice D is incorrect because captopril does not interact with grapefruit.

3. A client has a new prescription for furosemide. Which of the following instructions should the nurse include during discharge teaching?

• A. Avoid prolonged exposure to sunlight.
• B. Take this medication with a meal.
• C. Increase your intake of potassium-rich foods.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: C

Rationale: The correct instruction for a client taking furosemide is to increase their intake of potassium-rich foods. Furosemide is a loop diuretic that can lead to potassium loss, so increasing potassium-rich foods helps prevent hypokalemia. Choice A, avoiding prolonged exposure to sunlight, is not directly related to furosemide use. Choice B, taking the medication with a meal, is not a specific requirement for furosemide administration. Choice D, limiting fluid intake to 1 liter per day, is not the correct advice as furosemide is a diuretic that often requires increased fluid intake to prevent dehydration.

4. A client has a new prescription for levothyroxine. Which of the following findings should the nurse monitor for as a potential adverse effect of the medication?

• A. Increased heart rate.
• B. Weight loss.
• C. Hyperthermia.
• D. Decreased deep-tendon reflexes.

Correct answer: A

Rationale: Corrected Rationale: An increased heart rate is a common adverse effect of levothyroxine due to its role in boosting metabolism. Choice B, weight loss, is actually a therapeutic effect of levothyroxine as it helps in managing hypothyroidism by increasing the metabolic rate. Hyperthermia (Choice C) is not a typical adverse effect of levothyroxine. Decreased deep-tendon reflexes (Choice D) are not associated with levothyroxine use.

5. A nurse manager is planning to teach staff about critical pathways. Which of the following information should the nurse include?

• A. Critical pathways have unlimited timeframes for completion.
• B. Critical pathways are designed to decrease health care costs.
• C. Patients follow the critical pathway if variances occur.
• D. Budgets are used to create the critical pathway.

Correct answer: B

Rationale: The correct answer is B. Critical pathways are structured, multi-disciplinary plans of care designed to decrease health care costs and improve outcomes by standardizing and streamlining processes. Choice A is incorrect because critical pathways have specific timeframes for completion. Choice C is incorrect as patients are expected to follow the critical pathway without deviations to achieve optimal outcomes. Choice D is incorrect because budgets do not create critical pathways; rather, they are based on clinical guidelines and best practices.

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