Nursing Elites

1. A 48-year-old man presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?

• A. Hypothyroidism
• B. Hyperthyroidism
• C. Thyroiditis
• D. Thyroid cancer

Correct answer: A

Rationale: The scenario describes a classic presentation of hypothyroidism, supported by the laboratory findings of high TSH and low free T4 levels. In hypothyroidism, the body's thyroid hormone levels are inadequate, leading to symptoms like fatigue, weight gain, and cold intolerance. High TSH is a compensatory mechanism by the body to increase thyroid hormone production, which is deficient, resulting in a negative feedback loop. Therefore, the correct answer is hypothyroidism.

2. When providing dietary instructions to a client with cirrhosis, which dietary restriction is important for the nurse to emphasize?

• A. Low-protein diet
• B. Low-sodium diet
• C. High-fiber diet
• D. High-calcium diet

Correct answer: B

Rationale: A low-sodium diet is crucial for clients with cirrhosis to manage fluid retention and ascites. Excessive sodium intake can worsen fluid accumulation in the body, leading to complications. By restricting sodium intake, the client can help reduce fluid retention and maintain better overall health. Therefore, emphasizing a low-sodium diet is essential in the dietary management of cirrhosis. Choices A, C, and D are not the primary focus for cirrhosis management. While protein restriction may be necessary in advanced stages of liver disease, it is not the main dietary concern in cirrhosis. High-fiber and high-calcium diets are generally beneficial for overall health but are not specifically emphasized in cirrhosis management.

3. A client with chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which intervention should the nurse implement first?

• A. Administer bronchodilators as prescribed.
• B. Encourage pursed-lip breathing.
• C. Position the client in a high Fowler's position.
• D. Obtain a stat arterial blood gas (ABG) sample.

Correct answer: C

Rationale: In a client with COPD experiencing respiratory distress, the priority intervention should be to position the client in a high Fowler's position. This position helps optimize lung expansion, improve oxygenation, and reduce the work of breathing. Administering bronchodilators and encouraging pursed-lip breathing are important interventions but positioning the client to enhance respiratory function takes precedence in this situation. Obtaining an ABG sample may provide valuable information but is not the initial priority when addressing respiratory distress.

4. A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?

• A. Take with dairy products to increase absorption.
• B. Take on an empty stomach for best absorption.
• C. Avoid vitamin C while taking this medication.
• D. Take before bedtime.

Correct answer: B

Rationale: The correct advice for the administration of ferrous sulfate is to take it on an empty stomach for best absorption. This enhances the absorption of iron. If gastrointestinal upset occurs, the medication can be taken with food. Taking ferrous sulfate with dairy products is not recommended as calcium can inhibit iron absorption. Taking it before bedtime is also not recommended. Vitamin C can actually help with the absorption of iron and is often recommended to be taken alongside iron supplements to enhance absorption. Therefore, avoiding vitamin C while taking ferrous sulfate is not correct.

5. The healthcare provider is providing care to a client with a tracheostomy. Which action should the healthcare provider take to prevent tracheostomy complications?

• A. Use sterile technique when performing tracheostomy care.
• B. Suction the tracheostomy tube every hour.
• C. Keep the tracheostomy tube cuff inflated at all times.
• D. Change the tracheostomy ties daily.

Correct answer: A

Rationale: Using sterile technique when performing tracheostomy care is essential to prevent infections and other complications. Proper sterile technique helps reduce the risk of introducing harmful bacteria into the tracheostomy site, which can lead to infections and other serious issues. By maintaining a sterile environment during tracheostomy care, the healthcare provider can promote healing and prevent potential complications.

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