Nursing Elites

1. A patient with hypothyroidism should be advised to consume more of which nutrient?

• A. Calcium
• B. Iodine
• C. Vitamin C
• D. Iron

Correct answer: B

Rationale: The correct answer is B: Iodine. Iodine is crucial for the production of thyroid hormones. A deficiency in iodine can lead to hypothyroidism. Calcium (Choice A) is important for bone health but is not directly related to thyroid function. Vitamin C (Choice C) is essential for the immune system and skin health but does not play a significant role in thyroid function. Iron (Choice D) is vital for red blood cell production and oxygen transport but is not specifically relevant to hypothyroidism.

2. Six hours after major abdominal surgery, a male client complains of severe abdominal pain; is pale and perspiring; has a thready, rapid pulse; and states he feels faint. The nurse checks the client’s medication administration record and determines that the client receives another injection of pain medication in an hour. What is the appropriate action by the nurse?

• A. Explain to the client that it is too early to have an injection for pain
• B. Call the practitioner, report the client’s symptoms, and obtain further orders
• C. Reposition the client for greater comfort and turn on the television as a distraction
• D. Prepare the injection and administer it to the client early because of the severe pain

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is option B: Call the practitioner, report the client’s symptoms, and obtain further orders. The client is displaying symptoms that indicate potential complications, such as internal bleeding, which require immediate medical evaluation. Option A is incorrect because the client's condition suggests a more urgent need for assessment. Option C is inappropriate as it does not address the seriousness of the client's symptoms. Option D is dangerous and could exacerbate any underlying issue the client may be experiencing.

3. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip before initiating the Coumadin
• B. Check the client’s INR before beginning Coumadin
• C. Clarify the order with the healthcare provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.

4. The client is admitted to the emergency department complaining of acute epigastric pain and reports vomiting a large amount of bright red blood at home. Which interventions should the nurse implement?

• A. Assess the client’s vital signs
• B. Start an IV with an 18-gauge needle
• C. Begin iced saline lavage
• D. A, B

Correct answer: D

Rationale: In this scenario, the client's presentation of acute epigastric pain and vomiting bright red blood indicates a potential gastrointestinal bleeding emergency. Assessing the client's vital signs is essential to monitor their hemodynamic status. Starting an IV with an 18-gauge needle is crucial to establish access for potential fluid resuscitation or blood transfusion. Beginning iced saline lavage is not appropriate in this situation and could potentially delay necessary interventions. Therefore, the correct interventions for the nurse to implement are to assess the client’s vital signs and start an IV, making option D the most appropriate choice. Options A and B are correct because they are essential initial steps in managing gastrointestinal bleeding. Option C is incorrect as iced saline lavage is not indicated and may not address the urgent needs of the client in this critical situation.

5. Which of the following nursing interventions is important for a client scheduled to have a Guaiac Test?

• A. Avoid turnips, radish, and horseradish 3 days before
• B. Continue iron preparation to prevent further loss of iron
• C. Do not consume red meat 12 hours before the procedure
• D. Encourage consumption of dark-colored foods with caffeine

Correct answer: A

Rationale: The correct answer is A. Turnips, radish, and horseradish are known to cause false-positive results in a Guaiac Test, which is used to detect blood in the stool. Avoiding these foods is crucial to ensure accurate test results. Choice B is incorrect because iron preparations can interfere with the test results. Choice C is incorrect as red meat does not impact the Guaiac Test significantly. Choice D is incorrect as caffeine and dark-colored foods are not relevant to the preparation for a Guaiac Test.

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