Nursing Elites

1. A client is undergoing radiation therapy for treatment of thyroid cancer. Following the radiation, the client develops xerostomia. Which of the following best describes this condition?

• A. Cracks in the corners of the mouth
• B. Peeling skin from the tongue and gums
• C. Increased dental caries
• D. Dry mouth

Correct answer: D

Rationale: Xerostomia, also known as dry mouth, is a common side effect of radiation therapy in the head and neck region. It occurs when the salivary glands are damaged during treatment, reducing saliva production and causing a dry sensation in the mouth. The correct answer is 'Dry mouth' (option D). Choice A, 'Cracks in the corners of the mouth,' describes angular cheilitis, a condition linked to nutritional deficiencies or candida infection. Choice B, 'Peeling skin from the tongue and gums,' is more indicative of conditions like oral thrush or mucositis. Choice C, 'Increased dental caries,' is a consequence of reduced saliva flow but does not specifically describe xerostomia.

2. A patient with a cast on the right leg is being cared for by a nurse. Which of the following assessment findings would be most concerning for the nurse?

• A. The capillary refill time is 2 seconds
• B. The patient complains of itching and discomfort
• C. The cast has a foul-smelling odor
• D. The patient is on antibiotics

Correct answer: C

Rationale: A foul-smelling odor emanating from the cast is a concerning finding as it indicates the possibility of infection or the presence of a pressure ulcer. These conditions can lead to serious complications if not promptly addressed. It is crucial for the nurse to investigate further and take appropriate actions to prevent potential harm to the patient. The other options do not directly indicate a risk of infection or complications associated with the cast. Itching and discomfort are common complaints due to wearing a cast, and the patient being on antibiotics may be part of their treatment plan for an unrelated condition. Capillary refill time of 2 seconds is within the normal range and would not be a cause for immediate concern in this scenario.

3. A 45-year-old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The patient is living at home with her daughter. The nurse is most concerned about which side effect of ropinirole?

• A. Slurred speech
• B. Sudden dizziness
• C. Mask-like facial expression
• D. Stooped posture

Correct answer: B

Rationale: The correct answer is 'Sudden dizziness.' Dizziness and orthostatic hypotension are serious adverse effects of ropinirole that can lead to an increased risk of falls. Ropinirole belongs to the drug class of dopamine agonists, which mimic dopamine in the brain (Parkinson's Disease is characterized by a lack of dopamine). 'Slurred speech' is not a common side effect of ropinirole. 'Mask-like facial expression' and 'Stooped posture' are more associated with the progression of Parkinson's Disease itself rather than a side effect of ropinirole.

4. What preparation should be made for a client undergoing a KUB (Kidney, Ureter, Bladder) radiography test?

• A. Client must be NPO before the examination
• B. Enema should be administered before the examination
• C. Medicate the client with furosemide 20 mg IV 30 minutes before the examination
• D. No special orders are necessary for this examination

Correct answer: D

Rationale: The correct answer is that no special orders are necessary for a KUB radiography test. It is important to inform the client to remove any clothing, jewelry, or objects that may interfere with the test. Option A is incorrect because there is no need for the client to be NPO before this examination. Option B is incorrect as enemas are not routinely administered prior to a KUB radiography test. Option C is incorrect as there is no need to medicate the client with furosemide before this examination.

5. The nurse caring for Mrs. J is prepared to suction her endotracheal tube. Which of the following interventions will reduce hypoxia during this procedure?

• A. Hyperoxygenate Mrs. J for up to 60 seconds prior to starting
• B. Administer 15 mL of sterile fluid into the tube prior to suctioning
• C. Suction for no longer than 30 seconds at a time
• D. Wait 30 seconds after suctioning before attempting again

Correct answer: A

Rationale: Before suctioning a client's endotracheal tube, it is essential to hyperoxygenate the client for approximately 30 to 60 seconds. Hyperoxygenation helps increase oxygen delivery to the tissues, reducing the risk of hypoxia during and after the suctioning procedure. Administering fluid into the tube before suctioning (Choice B) is unnecessary and can lead to complications. Suctioning for no longer than 30 seconds at a time (Choice C) is a general guideline but does not specifically address reducing hypoxia. Waiting 30 seconds after suctioning before attempting again (Choice D) may lead to inadequate oxygenation and potential hypoxia, making it less effective in preventing this complication compared to hyperoxygenation prior to suctioning.

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