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 chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?

• A. Administer calcium gluconate.
• B. Encourage a diet high in potassium.
• C. Provide potassium supplements.
• D. Restrict sodium intake.

Correct answer: A

Rationale: Administering calcium gluconate is the appropriate intervention for a client with hyperkalemia. Calcium gluconate helps stabilize the heart by counteracting the effects of high potassium levels and reducing the risk of cardiac complications in individuals with hyperkalemia. Choices B, C, and D are incorrect. Encouraging a diet high in potassium or providing potassium supplements would exacerbate hyperkalemia. Restricting sodium intake is not directly related to addressing hyperkalemia.

3. The client has acute kidney injury (AKI). Which assessment finding requires immediate intervention?

• A. Urine output of 50 ml in the last hour.
• B. Serum potassium of 6.2 mEq/L.
• C. Blood pressure of 150/90 mm Hg.
• D. Serum creatinine of 2.5 mg/dL.

Correct answer: B

Rationale: An elevated serum potassium level of 6.2 mEq/L in a client with AKI can lead to life-threatening cardiac arrhythmias, necessitating immediate intervention. Hyperkalemia is a serious complication in AKI as impaired kidney function can result in the accumulation of potassium in the blood, posing a risk of cardiac arrest. Prompt treatment to lower potassium levels is crucial to prevent cardiac complications in this situation.

4. A client with cirrhosis of the liver is experiencing pruritus. Which intervention should the nurse implement to help relieve the client's symptoms?

• A. Administer acetaminophen (Tylenol).
• B. Apply lotion to the skin.
• C. Encourage a high-protein diet.
• D. Provide a warm bath.

Correct answer: B

Rationale: Pruritus is a common symptom in clients with cirrhosis due to bile salts accumulating in the skin. Applying lotion to the skin helps soothe the itching and can prevent skin breakdown. Acetaminophen can worsen liver damage in clients with cirrhosis as it is metabolized in the liver. Encouraging a high-protein diet is not directly related to relieving pruritus. Providing a warm bath may further dry the skin, exacerbating the itching. Therefore, the most appropriate intervention to help relieve pruritus in a client with cirrhosis is to apply lotion to the skin.

5. A 40-year-old woman presents with a history of chronic constipation, bloating, and abdominal pain. She notes that the pain is relieved with defecation. She denies any weight loss, blood in her stools, or nocturnal symptoms. Physical examination and routine blood tests are normal. What is the most likely diagnosis?

• A. Inflammatory bowel disease
• B. Irritable bowel syndrome
• C. Celiac disease
• D. Lactose intolerance

Correct answer: B

Rationale: The patient's symptoms of chronic constipation, bloating, abdominal pain relieved with defecation, absence of weight loss, blood in stools, or nocturnal symptoms, along with normal physical examination and routine blood tests, are indicative of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of any organic cause. It is a diagnosis of exclusion made based on symptom criteria, and the provided clinical scenario aligns with the typical presentation of IBS.

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