Nursing Elites

1. A client with psoriasis is prescribed topical corticosteroids. What side effect should the nurse monitor for?

• A. Monitor for weight gain and skin thinning.
• B. Assess for increased sensitivity to sunlight.
• C. Monitor for hair loss and excessive bruising.
• D. Report any signs of increased redness or itching.

Correct answer: D

Rationale: The correct answer is D. When a client with psoriasis is prescribed topical corticosteroids, the nurse should monitor for signs of increased redness or itching. This is because topical corticosteroids can cause skin thinning and increased redness if overused. Choices A, B, and C are incorrect because weight gain, sensitivity to sunlight, hair loss, and excessive bruising are not typically associated with the use of topical corticosteroids.

2. The nurse observes an unlicensed assistive personnel (UAP) positioning a newly admitted client who has a seizure disorder. The client is supine, and the UAP is placing soft pillows along the side rails. What action should the nurse take?

• A. Leave the pillows in place and document the action
• B. Inform the UAP that the pillows should be removed immediately
• C. Request that the pillows be replaced with firm padding
• D. Ensure that the side rails are padded and leave the pillows

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to inform the UAP that the pillows should be removed immediately. Soft pillows along the side rails do not provide sufficient protection during a seizure. The pillows could potentially increase the risk of injury, such as hitting the head or limbs against the hard side rails. Requesting firm padding or ensuring that the side rails are padded are not as effective as removing the pillows to prevent harm to the client. Leaving the pillows in place without addressing the potential risks would not be in the best interest of the client's safety.

3. A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication dosage is too high?

• A. Increased sensitivity to cold.
• B. Increased heart rate and palpitations.
• C. Improved energy levels.
• D. Improved tolerance to heat.

Correct answer: B

Rationale: The correct answer is B: Increased heart rate and palpitations. When a client with hypothyroidism is prescribed levothyroxine, these symptoms may indicate that the dosage is too high, causing the client to develop hyperthyroidism. Choices A, C, and D are incorrect. Increased sensitivity to cold is a symptom of hypothyroidism, improved energy levels are an expected outcome of levothyroxine therapy for hypothyroidism, and improved tolerance to heat is not a common sign of levothyroxine overdose.

4. A client receiving codeine for pain every 4 to 6 hours over 4 days. Which assessment should the nurse perform before administering the next dose?

• A. Auscultate the bowel sounds.
• B. Palpate the ankles for edema.
• C. Observe the skin for bruising.
• D. Measure the body temperature.

Correct answer: A

Rationale: The correct answer is A: Auscultate the bowel sounds. Codeine is known to cause constipation, so it is essential to assess bowel sounds before administering another dose to monitor for potential constipation or bowel motility issues. Palpating the ankles for edema (Choice B) is not directly related to codeine use or its side effects. Observing the skin for bruising (Choice C) is important but not specifically associated with codeine administration. Measuring body temperature (Choice D) is not a priority assessment related to codeine use; monitoring for constipation is more critical in this case.

5. A client who had a subtotal parathyroidectomy two days ago is now preparing for discharge. Which assessment finding requires immediate provider notification?

• A. Afebrile with a normal pulse.
• B. No bowel movement since surgery.
• C. No appetite for breakfast.
• D. A positive Chvostek's sign.

Correct answer: D

Rationale: A positive Chvostek's sign suggests hypocalcemia, which is a post-parathyroidectomy complication and requires prompt treatment. The other options are less urgent: being afebrile with a normal pulse is expected, no bowel movement since surgery can be managed with interventions like early ambulation and stool softeners, and no appetite for breakfast is common postoperatively and can be addressed without immediate provider notification.

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