Nursing Elites

1. Which assessment finding is expected with myxedema?

• A. Increased pulse rate
• B. Decreased temperature
• C. Fine tremors
• D. Weight loss

Correct answer: B

Rationale: Myxedema is characterized by a decreased metabolic rate, leading to manifestations such as decreased temperature. Therefore, the correct assessment finding expected with myxedema is a decreased temperature. Choices A, C, and D are incorrect because myxedema typically presents with a decreased pulse rate, not an increased pulse rate, absence of fine tremors (which are more common in hyperthyroidism), and weight gain rather than weight loss.

2. What are the risk factors for deep vein thrombosis (DVT) and how can it be prevented?

• A. Immobility and oral contraceptive use
• B. Pregnancy and smoking
• C. Obesity and varicose veins
• D. Hypertension and high cholesterol

Correct answer: A

Rationale: The correct answer is A: Immobility and oral contraceptive use. Immobility and oral contraceptive use are significant risk factors for deep vein thrombosis (DVT). Immobility leads to blood stasis, increasing the risk of clot formation, while oral contraceptive use can promote hypercoagulability. Prevention strategies for DVT include promoting mobility to enhance blood circulation and using anticoagulants to prevent clot formation. Choices B, C, and D are incorrect. While pregnancy and smoking can increase the risk of DVT, they are not the specific factors mentioned in the question. Similarly, obesity and varicose veins, as well as hypertension and high cholesterol, are not the primary risk factors associated with DVT.

3. When providing family education for those who have a relative with Alzheimer's disease about minimizing stress, which of the following suggestions is most relevant?

• A. Allow the client to rest four to five times during the day
• B. Assess the cognitive functioning of the client regularly
• C. Provide reality orientation even if the memory loss is severe
• D. Maintain consistency in environment, routine, and caregivers

Correct answer: D

Rationale: The most relevant suggestion for minimizing stress in individuals with Alzheimer's disease is to maintain consistency in the environment, routine, and caregivers. This approach helps create a sense of familiarity and security for the individual, reducing stress and anxiety. Choice A is incorrect as it suggests allowing the client to go to bed multiple times during the day, which may disrupt their routine and lead to confusion. Choice B is incorrect as continuously testing cognitive functioning can be overwhelming and stressful for the individual. Choice C is also incorrect as providing reality orientation in cases of severe memory loss can cause frustration and confusion, ultimately increasing stress levels.

4. A nurse is reviewing the medical record of a client with dementia. Which of the following findings should the nurse address first?

• A. Psychosocial stressors
• B. Restlessness and agitation
• C. Frequent wandering at night
• D. Urinary incontinence

Correct answer: B

Rationale: In clients with dementia, restlessness and agitation are important symptoms that the nurse should address first. These symptoms can indicate underlying issues such as pain, discomfort, or unmet needs, and addressing them promptly can prevent complications. Psychosocial stressors may contribute to the client's condition but should not be the initial priority. Frequent wandering at night and urinary incontinence are also common in dementia but do not pose immediate risks compared to restlessness and agitation.

5. What is the priority for the nurse when caring for a patient with a chest tube?

• A. Ensure tube patency and observe for air leaks
• B. Maintain sterile technique during dressing changes
• C. Monitor drainage and record output
• D. Observe for signs of infection and monitor for subcutaneous emphysema

Correct answer: A

Rationale: The priority for the nurse when caring for a patient with a chest tube is to ensure tube patency and observe for air leaks. This is essential to prevent complications such as pneumothorax and ensure the patient's lung function. While maintaining sterile technique during dressing changes, monitoring drainage, recording output, and observing for signs of infection and subcutaneous emphysema are also important, ensuring tube patency takes precedence as it directly impacts the patient's respiratory status and overall safety.

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