Nursing Elites

1. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?

• A. Increase thyroid hormone production
• B. Suppress thyroid hormone production
• C. Enhance iodine absorption
• D. Stimulate the thyroid gland

Correct answer: B

Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.

2. A client with heart failure is prescribed furosemide (Lasix). Which instruction should the nurse include in the client's teaching plan?

• A. Take the medication before bedtime.
• B. Report any weight gain of more than 2 pounds in a day.
• C. Increase your intake of high-sodium foods.
• D. Limit your fluid intake to less than 1 liter per day.

Correct answer: B

Rationale: In heart failure, fluid retention is a concern. Furosemide helps manage this by promoting diuresis. Instructing the client to report weight gain exceeding 2 pounds in a day is crucial as it can indicate fluid accumulation, prompting timely intervention to prevent worsening heart failure symptoms and complications.

3. A 32-year-old woman presents with a 10-month history of an intermittent burning sensation in the epigastrium that is sometimes related to eating. She has heard about bacteria that can cause gastrointestinal (GI) symptoms. She has had no change in her weight and denies dysphagia. Her laboratory tests are normal. Which of the following would you recommend?

• A. Serum qualitative test for H. pylori
• B. Refer for endoscopy
• C. Obtain an upper GI series
• D. Treat her for H. pylori infection

Correct answer: A

Rationale: The patient presents with dyspepsia, described as an intermittent burning sensation in the epigastrium, sometimes related to eating. In individuals under 45 years without warning signs such as anemia, weight loss, or dysphagia, a serum qualitative test for H. pylori is recommended to document H. pylori infection, especially if the patient has not been previously treated. It's important to note that a serum IgG can remain positive post-eradication. If H. pylori-positive patients do not respond to treatment, an endoscopy would be the next step for evaluation. An upper GI series is less sensitive than endoscopy in detecting lesions of the upper GI tract and cannot specifically detect H. pylori. Empiric therapy for H. pylori without confirmation is not recommended.

4. A client with heart failure is receiving intravenous furosemide (Lasix). Which assessment finding indicates that the medication is having the desired effect?

• A. Decreased peripheral edema.
• B. Elevated blood pressure.
• C. Increased heart rate.
• D. Decreased urine output.

Correct answer: A

Rationale: The correct answer is A: 'Decreased peripheral edema.' In a client with heart failure receiving furosemide, decreased peripheral edema indicates that the medication is effectively reducing fluid overload. Furosemide is a diuretic that helps the body eliminate excess fluid and salt through increased urine output, leading to a reduction in peripheral edema, which is a common symptom of heart failure. Monitoring and recognizing this improvement in edema are crucial in managing heart failure effectively.

5. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

• A. Relieve neuropathic pain
• B. Reduce inflammation
• C. Enhance opioid analgesia
• D. Suppress cough

Correct answer: A

Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.

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