Nursing Elites

1. A client with hypothyroidism is prescribed levothyroxine. What should the nurse include in the teaching plan about this medication?

• A. Take the medication with a full meal
• B. Take the medication on an empty stomach
• C. Take the medication at bedtime
• D. Take the medication as needed for symptoms

Correct answer: B

Rationale: The correct answer is B: 'Take the medication on an empty stomach.' Levothyroxine should be taken on an empty stomach to enhance absorption and effectiveness. The medication is typically taken in the morning before breakfast. Choice A is incorrect because taking levothyroxine with a full meal can decrease its absorption. Choice C is incorrect because bedtime dosing may lead to insomnia. Choice D is incorrect because levothyroxine is a daily medication for hypothyroidism, not to be taken as needed for symptoms.

2. A client is admitted with a large bowel obstruction. What finding should the nurse report immediately?

• A. Absence of bowel sounds in all four quadrants.
• B. Abdominal distention with a firm, rigid abdomen.
• C. Frequent, small, liquid stools.
• D. Nausea and vomiting that worsens after meals.

Correct answer: B

Rationale: Abdominal distention with a firm, rigid abdomen is a concerning sign that may indicate perforation, which requires immediate intervention. The rigidity suggests a complication of the large bowel obstruction. Absence of bowel sounds in all four quadrants, option A, is a common finding in a bowel obstruction but not as alarming as a rigid abdomen. Frequent, small, liquid stools, option C, are not typical findings in a large bowel obstruction; instead, constipation is more common. Nausea and vomiting that worsens after meals, option D, are also common symptoms of a bowel obstruction but do not indicate an immediate life-threatening complication like a perforation.

3. The nurse is caring for a client with acute pancreatitis who is reporting severe abdominal pain. Which nursing intervention should the nurse implement first?

• A. Assess the client's bowel sounds
• B. Administer prescribed pain medication
• C. Encourage the client to sit upright
• D. Provide clear fluids to the client

Correct answer: B

Rationale: In a client with acute pancreatitis experiencing severe abdominal pain, the priority nursing intervention is to provide pain relief. Administering prescribed pain medication is essential to improve comfort and reduce pain, which can help stabilize the client's condition. Assessing bowel sounds (Choice A) may be necessary but is not the immediate priority over pain management. Encouraging the client to sit upright (Choice C) and providing clear fluids (Choice D) are not the primary interventions for addressing severe abdominal pain in acute pancreatitis.

4. The nurse is providing care for a client with suspected deep vein thrombosis (DVT) in the left leg. Which action should the nurse take first?

• A. Encourage the client to ambulate
• B. Apply a warm compress to the left leg
• C. Elevate the client's left leg
• D. Administer a prescribed anticoagulant

Correct answer: C

Rationale: Elevating the affected leg promotes venous return and reduces swelling, which is a priority intervention for a client with suspected DVT. This action helps prevent the thrombus from dislodging and causing further complications. Encouraging ambulation may dislodge the clot, leading to a pulmonary embolism. Applying a warm compress can increase blood flow to the area, potentially dislodging the clot. Administering anticoagulants is essential but should not be the first action as elevation helps to reduce the risk of complications associated with DVT.

5. A middle-aged woman talks to the nurse in the healthcare provider's office about uterine fibroids, also called leiomyomas or myomas. What statement by the woman indicates more education is needed?

• A. I am one out of every 4 women that get fibroids, and among women my age, between the 30s or 40s, fibroids occur more frequently.
• B. My fibroids are noncancerous tumors that grow slowly.
• C. The associated problems I have had are pelvic pressure and pain, urinary incontinence, frequent urination or urine retention, and constipation.
• D. Fibroids that cause no problems still need to be taken out.

Correct answer: D

Rationale: The correct answer is D because fibroids that do not cause symptoms do not necessarily need to be removed unless they pose other health risks. Choice A provides accurate information about the prevalence of fibroids among women of the woman's age group. Choice B correctly describes fibroids as noncancerous tumors. Choice C lists common symptoms associated with fibroids, which is relevant information. However, choice D is incorrect as fibroids that are asymptomatic or not causing problems usually do not require treatment, unless they lead to complications or health risks.

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