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. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of 'suppression'?

• A. "I don't remember anything about what happened to me."
• B. "I'd rather not talk about it right now."
• C. "It's all the other guy's fault! He was going too fast."
• D. "My mother is heartbroken about this."

Correct answer: B

Rationale: The correct answer is B because the statement "I'd rather not talk about it right now" indicates that the client is consciously choosing to avoid discussing the distressing issue, which aligns with the mechanism of suppression. Choice A does not involve active avoidance but rather memory loss, which is not suppression. Choice C involves blaming others, which is a defense mechanism known as projection. Choice D involves expressing emotions rather than avoiding them, which does not align with suppression.

3. Which of the following qualifications is not required for a Nurse Supervisor at the provincial level?

• A. BSN, RN
• B. at least 3 years experience
• C. Master's in public health
• D. at least 5 years experience in public health

Correct answer: B

Rationale: The correct answer is B because the qualifications for a Nurse Supervisor at the provincial level include a BSN, RN, and a Master's in public health, along with a minimum of 5 years of experience in public health. Choice B, which states 'at least 3 years experience,' is incorrect as the requirement is for at least 5 years of experience in public health. Choices A, C, and D are necessary qualifications for a Nurse Supervisor at the provincial level based on the provided information.

4. A client with cirrhosis of the liver is experiencing ascites. The nurse should implement which of the following interventions?

• A. Restrict fluid intake
• B. Increase sodium intake
• C. Encourage high-protein diet
• D. Administer diuretics

Correct answer: D

Rationale: Corrected Rationale: Ascites, the accumulation of fluid in the abdominal cavity, is a common complication of cirrhosis. Diuretics are the primary intervention to manage ascites by promoting the excretion of excess fluid from the body, thus reducing abdominal swelling. Restricting fluid intake (Choice A) would not be appropriate as it may lead to dehydration. Increasing sodium intake (Choice B) is contraindicated as it can worsen fluid retention. Encouraging a high-protein diet (Choice C) is not directly related to managing ascites.

5. The nurse uses the DRG (Diagnosis Related Group) manual to

• A. Classify nursing diagnoses from the client's health history
• B. Identify findings related to a medical diagnosis
• C. Determine reimbursement for a medical diagnosis
• D. Implement nursing care based on case management protocol

Correct answer: C

Rationale: The DRG manual is used to determine the reimbursement rate for medical diagnoses and treatments under the prospective payment system used by healthcare facilities. Choice A is incorrect because the DRG manual is not used to classify nursing diagnoses, but rather to group medical diagnoses for billing purposes. Choice B is incorrect as the DRG manual is not used to identify findings related to medical diagnoses, but rather to standardize payments for medical services. Choice D is incorrect as the DRG manual is not used to implement nursing care based on case management protocol, but rather to set reimbursement rates.

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