Nursing Elites

1. A client with hyperthyroidism is prescribed methimazole. Which adverse effect should the nurse monitor for?

• A. Agranulocytosis
• B. Hypoglycemia
• C. Bradycardia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is Agranulocytosis. Methimazole, used to treat hyperthyroidism, can lead to agranulocytosis, a severe decrease in white blood cells. This condition increases the risk of infections and requires immediate medical attention. Hypoglycemia (choice B) is not a common adverse effect of methimazole. Bradycardia (choice C) is unlikely as methimazole tends to have minimal effects on heart rate. Hypercalcemia (choice D) is not associated with methimazole use.

2. Following surgical repair of a cleft palate, what should be used to prevent injury to the suture line?

• A. Straw
• B. Spoon
• C. Syringe
• D. Cup

Correct answer: D

Rationale: Following surgical repair of a cleft palate, a cup should be used to prevent injury to the suture line. Utensils such as straws, spoons, droppers, and syringes should be avoided as they can cause trauma to the surgical site. Using a cup reduces the risk of disrupting the sutures and promotes proper healing.

3. When interacting with the parents of a SIDS infant, the nurse should attempt to assist the parents with:

• A. Encouraging the parents to have another baby.
• B. Encouraging the parents to remain stoic.
• C. Allaying feelings of guilt and blame.
• D. Learning how the event could have been prevented.

Correct answer: C

Rationale: The correct answer is C: Allaying feelings of guilt and blame. When parents experience the loss of a SIDS infant, they often struggle with intense feelings of guilt and self-blame. The nurse's role is to provide emotional support and help alleviate these feelings. Choices A and B are incorrect as encouraging the parents to have another baby or to remain stoic is not appropriate or helpful in this situation. Choice D is also incorrect because focusing on how the event could have been prevented may exacerbate feelings of guilt and is not the immediate priority in supporting grieving parents.

4. A client is currently receiving an infusion labeled as 5% dextrose injection 500 ml with heparin sodium 25,000 units at 14 mL/hour per pump. A prescription is received to change the rate of the infusion to heparin 1,000 units/hour. How many ml/hour should the nurse program the infusion pump?

• A. 16 ml/hour.
• B. 18 ml/hour.
• C. 20 ml/hour.
• D. 22 ml/hour.

Correct answer: C

Rationale: To deliver 1,000 units/hour from a solution with 25,000 units in 500 ml, the rate should be set to 20 ml/hour. This is calculated by determining that the solution has 50 units/ml (25,000 units / 500 ml = 50 units/ml) and then dividing the required 1,000 units/hour by 50 units/ml, resulting in 20 ml/hour. Therefore, the nurse should program the infusion pump to deliver heparin at 20 ml/hour. Choices A, B, and D are incorrect as they do not align with the calculated rate of 20 ml/hour.

5. A client with Cushing's Syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse?

• A. Irregular apical pulse
• B. Purple marks on the skin of the abdomen
• C. Quarter-sized blood spot on the dressing
• D. Pitting ankle edema

Correct answer: A

Rationale: The correct answer is A: Irregular apical pulse. In a client recovering from a laparoscopic procedure with Cushing's Syndrome, an irregular apical pulse can be indicative of a life-threatening arrhythmia and requires immediate intervention. Choices B, C, and D are not as urgent as an irregular apical pulse. Purple marks on the skin of the abdomen may be related to Cushing's Syndrome, a quarter-sized blood spot on the dressing can be managed with appropriate wound care, and pitting ankle edema may be expected postoperatively but does not require immediate intervention.

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