Nursing Elites

1. Which of the following is an expected finding in a patient with hypothyroidism?

• A. Weight gain.
• B. Weight loss.
• C. Increased appetite.
• D. Diarrhea.

Correct answer: A

Rationale: Weight gain is an expected finding in hypothyroidism due to the decreased metabolic rate. Hypothyroidism leads to a slowing down of bodily functions, including metabolism, which can result in weight gain. Weight loss (Choice B) is more commonly associated with hyperthyroidism where there is an increase in metabolic rate. Increased appetite (Choice C) is also more typical of hyperthyroidism as the body is burning energy at a faster rate. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; instead, constipation is more often observed due to the slowing down of the digestive system.

2. After a client with peripheral vascular disease undergoes a right femoral-popliteal bypass graft, their blood pressure drops from 124/80 to 94/62. What should the nurse assess first?

• A. IV fluid infusion.
• B. Pedal pulses.
• C. Nasal cannula oxygen flow rate.
• D. Capillary refill time.

Correct answer: B

Rationale: Assessing pedal pulses is crucial in this situation as it helps determine the adequacy of perfusion to the lower extremity following a bypass graft. A decrease in blood pressure postoperatively could indicate decreased perfusion, making the assessment of pedal pulses a priority to ensure proper circulation. Checking IV fluid infusion, nasal cannula oxygen flow rate, or capillary refill time are not the immediate priorities in this scenario and would not provide direct information about perfusion to the affected extremity.

3. A client with nephrotic syndrome is being assessed by a nurse. For which clinical manifestations should the nurse assess? (Select all that apply.)

• A. Proteinuria
• B. Hypoalbuminemia
• C. Lipiduria
• D. All of the above

Correct answer: D

Rationale: Nephrotic syndrome is characterized by glomerular damage, leading to proteinuria (excessive protein in the urine), hypoalbuminemia (low levels of albumin in the blood), and lipiduria (lipids in the urine). These manifestations are key indicators of nephrotic syndrome. Edema, often severe, is also common due to decreased plasma oncotic pressure from hypoalbuminemia. The correct answer is 'All of the above' because all three manifestations are associated with nephrotic syndrome. Dehydration is not a typical finding in nephrotic syndrome as it is more commonly associated with fluid retention and edema. Dysuria is a symptom of cystitis, not nephrotic syndrome. CVA tenderness is more indicative of inflammatory changes in the kidney rather than nephrotic syndrome.

4. Which of the following conditions is the most significant risk factor for the development of type 2 diabetes mellitus?

• A. Cigarette smoking.
• B. High-cholesterol diet.
• C. Obesity.
• D. Hypertension.

Correct answer: C

Rationale: Obesity is the most significant risk factor for developing type 2 diabetes mellitus due to its role in insulin resistance. Excess body fat, especially around the abdomen, leads to increased production of inflammatory markers and hormones that can cause insulin resistance. While cigarette smoking, high-cholesterol diet, and hypertension can contribute to health issues, they are not as directly linked to the development of type 2 diabetes mellitus as obesity.

5. A client is getting out of bed for the first time since surgery. The client complains of dizziness after the nurse raises the head of the bed. Which of the following actions should the nurse take first?

• A. Checking the client’s blood pressure
• B. Checking the oxygen saturation level
• C. Having the client take some deep breaths
• D. Lowering the head of the bed slowly until the dizziness is relieved

Correct answer: D

Rationale: When a client experiences dizziness after being positioned upright for the first time post-surgery, the initial action the nurse should take is to lower the head of the bed slowly until the dizziness subsides. This maneuver helps alleviate the dizziness by allowing the body to adapt gradually to the change in position. Subsequently, the nurse should assess the client's pulse and blood pressure. Checking the blood pressure is essential to evaluate the circulatory status and rule out orthostatic hypotension as a cause of dizziness. Checking the oxygen saturation level and having the client take deep breaths are not the priority in this scenario as the primary concern is addressing the circulatory issue causing dizziness, not a respiratory problem.

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