Nursing Elites

1. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

2. 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.

3. What does the concept of 'health equity' refer to?

• A. Equal access to healthcare for all individuals
• B. Providing the same treatments to everyone
• C. Eliminating health disparities among different population groups
• D. Focusing on the healthcare needs of the wealthy

Correct answer: C

Rationale: The concept of health equity refers to eliminating health disparities among different population groups. This means ensuring that everyone has a fair and just opportunity to be as healthy as possible, regardless of social determinants such as race, ethnicity, income, or geographic location. Choice A is incorrect because health equity goes beyond just access to healthcare and focuses on achieving health equality. Choice B is incorrect as health equity considers individual needs rather than providing the same treatments to everyone. Choice D is incorrect as health equity aims to address disparities and inequalities, not just focus on the healthcare needs of the wealthy.

4. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

5. 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.

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