Nursing Elites

1. A mother reports that she has been applying triple antibiotic ointment for her son's athlete's foot for two days with no improvement. What should the nurse instruct?

• A. Continue using the ointment and keep the area clean.
• B. Stop using the ointment and encourage the feet to be dried completely.
• C. Apply a different antifungal medication instead.
• D. Reapply the ointment twice a day for a longer period.

Correct answer: B

Rationale: Antibiotic ointment is ineffective against athlete's foot, which is a fungal infection. The nurse should instruct the mother to stop using the ointment and ensure the feet are dried properly, as moisture exacerbates fungal infections. Applying a different antifungal medication is a valid option, but addressing the moisture issue by drying the feet completely is the immediate priority. Continuing to use the antibiotic ointment or reapplying it for a longer period will not treat the fungal infection effectively.

2. A male client reports numbness and tingling in his fingers and around his mouth. What laboratory value should the nurse review?

• A. Capillary glucose.
• B. Serum calcium.
• C. Urine specific gravity.
• D. White blood cell count.

Correct answer: B

Rationale: The correct answer is B, Serum calcium. Numbness and tingling in the fingers and around the mouth are indicative of hypocalcemia, a condition characterized by low calcium levels in the blood. Reviewing the client's serum calcium levels is crucial in this situation to assess for hypocalcemia. Choice A, Capillary glucose, is incorrect because symptoms described are not typically associated with glucose abnormalities. Choice C, Urine specific gravity, and Choice D, White blood cell count, are unrelated to the symptoms presented and are not indicative of the client's condition.

3. During an acute exacerbation of asthma, what is the nurse's first action for a client experiencing this condition?

• A. Administer a bronchodilator as prescribed.
• B. Check the client's oxygen saturation.
• C. Reassure the client and encourage deep breathing.
• D. Provide emotional support to reduce anxiety.

Correct answer: A

Rationale: The correct first action when managing an acute exacerbation of asthma is to administer a bronchodilator as prescribed. Bronchodilators help open the airways and improve breathing in individuals experiencing an asthma exacerbation. Checking oxygen saturation (Choice B) is important but not the first action. Reassuring the client and encouraging deep breathing (Choice C) can be beneficial but should come after administering the bronchodilator. Providing emotional support to reduce anxiety (Choice D) is important but is not the initial priority in managing an acute exacerbation of asthma.

4. An older client who had a subtotal parathyroidectomy is preparing for discharge. What 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 indicates hypocalcemia, a complication after parathyroid surgery that requires immediate attention. This sign is manifested by facial muscle twitching when the facial nerve in front of the ear is tapped, indicating neuromuscular irritability due to low calcium levels. Afebrile with a normal pulse (Choice A) is a normal finding and does not require immediate notification. No bowel movement since surgery (Choice B) is common postoperatively due to anesthesia effects and pain medications and usually resolves within a few days; it does not require immediate notification unless accompanied by other concerning symptoms. No appetite for breakfast (Choice C) is a common postoperative finding and does not require immediate notification unless it persists and leads to dehydration or malnutrition.

5. A client is receiving IV fluid therapy for dehydration. Which assessment finding indicates that the client's fluid status is improving?

• A. Urine output increases to 50 mL/hour
• B. Client reports feeling more thirsty
• C. Blood pressure decreases from 120/80 to 110/70
• D. Heart rate increases from 80 to 100 beats per minute

Correct answer: A

Rationale: An increase in urine output is a positive sign that the client's hydration status is improving. It indicates that the kidneys are functioning well and that fluid therapy is effective. Increased urine output helps to eliminate excess fluid and waste products from the body. Choices B, C, and D are incorrect. Feeling more thirsty (choice B) is a sign of dehydration, not improvement. A decrease in blood pressure (choice C) and an increase in heart rate (choice D) are not typically indicative of improving fluid status during IV fluid therapy for dehydration.

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