Nursing Elites

1. The healthcare provider is caring for a client who has just undergone a thyroidectomy. Which assessment finding requires immediate intervention?

• A. Hoarse voice.
• B. Difficulty swallowing.
• C. Numbness and tingling around the mouth.
• D. Sore throat.

Correct answer: C

Rationale: Numbness and tingling around the mouth can indicate hypocalcemia, a potential complication after thyroidectomy. Hypocalcemia can occur due to inadvertent injury or removal of the parathyroid glands during the thyroidectomy, leading to decreased calcium levels. As a result, the client may experience symptoms such as numbness, tingling, muscle cramps, or spasms. Prompt intervention is necessary to prevent severe complications like tetany or seizures. Therefore, the healthcare provider should address numbness and tingling around the mouth immediately to prevent further deterioration of calcium levels and potential serious outcomes. Choices A, B, and D are not typically associated with immediate post-thyroidectomy complications and can be addressed after ensuring the client's calcium levels are stable.

2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed ipratropium. What is the primary action of this medication?

• A. Reduce inflammation
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Ipratropium is an anticholinergic bronchodilator that primarily works to relieve bronchospasm by dilating the airways and improving airflow in patients with COPD. It does not have a significant effect on reducing inflammation, suppressing cough, or thinning respiratory secretions.

3. A client with chronic kidney disease (CKD) is scheduled for a renal biopsy. Which pre-procedure instruction should the nurse provide?

• A. Maintain a low-protein diet for 24 hours before the biopsy.
• B. Avoid taking anticoagulant medications for one week before the biopsy.
• C. Drink plenty of fluids before the procedure.
• D. Take your routine medications with a full glass of water before the biopsy.

Correct answer: B

Rationale: The correct pre-procedure instruction the nurse should provide to a client with chronic kidney disease (CKD) scheduled for a renal biopsy is to avoid taking anticoagulant medications for one week before the biopsy. This instruction is crucial to reduce the risk of bleeding during the procedure, as anticoagulants can increase the chance of bleeding complications. Choices A, C, and D are incorrect because maintaining a low-protein diet, drinking plenty of fluids, or taking routine medications with water are not specifically related to reducing the risk of bleeding associated with a renal biopsy in a client with CKD.

4. A client with a history of hypertension is prescribed hydrochlorothiazide. Which instruction should the nurse include in the client's teaching?

• A. Take this medication in the morning.
• B. Avoid foods high in potassium.
• C. Monitor your blood pressure regularly.
• D. Decrease your intake of high-sodium foods.

Correct answer: C

Rationale: Regular monitoring of blood pressure is crucial for individuals with hypertension to assess the effectiveness of the prescribed medication and to ensure blood pressure is within the target range. This helps in managing hypertension and preventing complications associated with high blood pressure. Choices A, B, and D are incorrect because while taking the medication in the morning may be recommended for some drugs, it is not the key instruction for hydrochlorothiazide. Avoiding foods high in potassium and decreasing high-sodium foods are important dietary considerations for certain conditions, but they are not the immediate focus when starting hydrochlorothiazide.

5. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

• A. Reduce mucus production
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.

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