Nursing Elites

1. A client with hypothyroidism is receiving levothyroxine (Synthroid). The nurse should monitor the client for which of the following side effects?

• A. Tachycardia
• B. Hypotension
• C. Weight gain
• D. Bradycardia

Correct answer: A

Rationale: The correct answer is A: Tachycardia. Levothyroxine, used to treat hypothyroidism, can lead to increased metabolism, causing tachycardia as a side effect. Monitoring for tachycardia is essential to ensure the client's safety. Choices B, Hypotension, and C, Weight gain, are incorrect as levothyroxine is not typically associated with causing hypotension or weight gain. Choice D, Bradycardia, is also incorrect as levothyroxine-induced bradycardia is not a common side effect.

2. Care provided by specialists in health facilities such as medical centers, regional, and provincial hospitals falls under which level of care?

• A. Secondary level care
• B. Primary care
• C. Tertiary care
• D. Intermediate care

Correct answer: C

Rationale: Tertiary care is the correct answer because it involves specialized care provided by medical centers and regional or provincial hospitals. Primary care (Choice B) refers to basic healthcare services usually delivered by general practitioners, nurses, and other healthcare professionals. Secondary care (Choice A) involves specialized services provided by medical specialists and other health professionals who generally do not have first contact with patients. Intermediate care (Choice D) is not a recognized level of care in the typical healthcare system hierarchy; it may cause confusion as it's not a standard term used to describe levels of care.

3. The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to:

• A. Reports of difficulty falling and staying asleep
• B. Expression of persistent suicidal thoughts
• C. Lack of enjoyment in usual pleasures
• D. Reduced senses of taste and smell

Correct answer: C

Rationale: The correct answer is C: Lack of enjoyment in usual pleasures. Anhedonia is the inability to feel pleasure in normally pleasurable activities. Choice A, reports of difficulty falling and staying asleep, is more indicative of insomnia rather than anhedonia. Choice B, expression of persistent suicidal thoughts, is related to suicidal ideation and not anhedonia. Choice D, reduced senses of taste and smell, is more associated with disturbances in the sense of taste and smell, not anhedonia.

4. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.

5. The nurse is evaluating the growth and development of a toddler with AIDS. The nurse would anticipate finding that the child has

• A. Achieved developmental milestones at an erratic rate
• B. Delay in musculoskeletal development
• C. Displayed difficulty with speech development
• D. Delay in achievement of most developmental milestones

Correct answer: D

Rationale: Children with AIDS often experience delays in achieving developmental milestones, affecting their overall growth and development. This delay can impact various areas of development, not limited to a specific aspect like musculoskeletal or speech development. While some children may achieve milestones at varying rates (choice A), the general trend is a delay in multiple milestones (choice D). Musculoskeletal development (choice B) and speech development (choice C) may be affected but are not as comprehensive as the delay in most developmental milestones.

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