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. A client who delivered a 7-pound infant 12 hours ago is complaining of a severe headache. The client's blood pressure is 110/70, respiratory rate is 18 breaths/minute, heart rate is 74 beats/minute, and temperature is 98.6º F. The client's fundus is firm and one fingerbreadth above the umbilicus. What action should the healthcare team implement first?

• A. Notify the healthcare provider of the assessment findings.
• B. Determine if the client received anesthesia during delivery.
• C. Assign a licensed nurse to reassess the client's vital signs.
• D. Obtain a STAT hemoglobin and hematocrit.

Correct answer: B

Rationale: The correct action to implement first is to determine if the client received anesthesia during delivery. Anesthesia can be a potential cause of postpartum headaches. This information is crucial in assessing and managing the client's condition effectively before considering other interventions. It helps in identifying possible contributing factors to the client's complaint of a severe headache and guides the healthcare team in providing appropriate care and treatment.

3. A healthcare provider is providing dietary teaching to a client with cholecystitis. Which type of diet should the healthcare provider recommend?

• A. High-fiber, low-fat diet
• B. Low-fiber, high-protein diet
• C. Low-fat, low-cholesterol diet
• D. High-protein, high-fat diet

Correct answer: C

Rationale: In cholecystitis, a low-fat, low-cholesterol diet is recommended to manage symptoms and reduce inflammation by reducing the workload on the gallbladder. This diet helps prevent gallbladder attacks and complications.

4. A patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include in the patient teaching?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: Patients prescribed methotrexate should be advised to take folic acid supplements as prescribed. Methotrexate can deplete folic acid levels, leading to side effects. By taking folic acid supplements as directed, the patient can reduce the risk of experiencing adverse effects associated with methotrexate therapy. It is important to note that the effects of methotrexate may not be immediate, so realistic expectations should be set with the patient. Alcohol should be avoided while taking methotrexate due to potential interactions and increased risk of liver toxicity. There is no specific recommendation to limit fluid intake to 1 liter per day in relation to methotrexate therapy.

5. The healthcare provider in the outpatient clinic has obtained health histories for these new patients. Which patient may need referral for genetic testing?

• A. 35-year-old patient whose maternal grandparents died after strokes at ages 90 and 96
• B. 18-year-old patient with a positive pregnancy test whose first child has cerebral palsy
• C. 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease
• D. 50-year-old patient with a history of cigarette smoking who is complaining of dyspnea

Correct answer: C

Rationale: The 34-year-old patient who has a sibling with newly diagnosed polycystic kidney disease may need referral for genetic testing. Polycystic kidney disease is an autosomal dominant disorder that can be asymptomatic until later in life. Presymptomatic testing can provide valuable information for guiding lifestyle and family planning decisions. The other patients do not present indications for genetic testing based on the information provided in their health histories. The 35-year-old patient's maternal grandparents' strokes are not indicative of a need for genetic testing. The 18-year-old patient's child having cerebral palsy is not a direct indication for genetic testing of the patient herself. The 50-year-old patient's symptoms are more likely related to smoking and respiratory issues, not genetic predisposition to a specific disease.

Similar Questions