Nursing Elites

1. A client has a urine specific gravity of 1.040. What action should the nurse take?

• A. Obtain a urine culture and sensitivity.
• B. Place the client on restricted fluids.
• C. Assess the client’s creatinine level.
• D. Increase the client’s fluid intake.

Correct answer: D

Rationale: A urine specific gravity of 1.040 is higher than the normal range (1.005 to 1.030) and can indicate dehydration, decreased kidney blood flow, or the presence of antidiuretic hormone. In this situation, the priority action should be to increase the client's fluid intake to address the high specific gravity. Obtaining a urine culture, placing the client on restricted fluids, or assessing the creatinine level would not directly address the underlying issue of high urine specific gravity caused by dehydration or other factors.

2. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action?

• A. Monitor hemoglobin and hematocrit
• B. Encourage turning and deep breathing
• C. Administer IV antibiotics as prescribed
• D. Auscultate for presence of bowel sounds

Correct answer: C

Rationale: The priority nursing action for a client diagnosed with acute pyelonephritis is to administer IV antibiotics as prescribed. Acute pyelonephritis is a serious kidney infection that requires prompt antibiotic therapy to prevent systemic complications and worsening of the infection. While monitoring hemoglobin and hematocrit (Choice A) is important, it is not the priority in the acute phase of infection. Encouraging turning and deep breathing (Choice B) and auscultating for bowel sounds (Choice D) are relevant aspects of care but do not take precedence over initiating antibiotic treatment to address the infection promptly.

3. A client has just returned to the nursing unit after computerized tomography (CT) with contrast medium. Which of the following actions should the nurse plan to take as part of routine after-care for this client?

• A. Administering a laxative
• B. Encouraging fluid intake
• C. Maintaining the client on strict bed rest
• D. Holding all medications for at least 2 hours

Correct answer: B

Rationale: After CT scanning with contrast medium, the client does not require special restrictions or interventions. Encouraging fluid intake is important to help flush out the contrast dye and prevent dehydration. Administering a laxative (Choice A) is unnecessary and not indicated after CT with contrast. Maintaining the client on strict bed rest (Choice C) is not necessary unless specified by the healthcare provider. Holding all medications for at least 2 hours (Choice D) is not a standard practice after CT with contrast.

4. Which of the following is the best indicator of fluid balance in a patient with heart failure?

• A. Daily weight measurements.
• B. Monitoring intake and output.
• C. Assessing skin turgor.
• D. Checking for peripheral edema.

Correct answer: A

Rationale: Daily weight measurements are the best indicator of fluid balance in a patient with heart failure. Changes in weight reflect fluid retention or loss more accurately than other methods. Monitoring intake and output (choice B) is essential but may not provide a comprehensive picture of fluid status. Skin turgor (choice C) and checking for peripheral edema (choice D) are more indicative of dehydration and fluid overload, respectively, rather than overall fluid balance.

5. Which of the following is a key symptom of hypothyroidism?

• A. Weight loss.
• B. Heat intolerance.
• C. Cold intolerance.
• D. Increased appetite.

Correct answer: C

Rationale: Cold intolerance is a key symptom of hypothyroidism because a decreased metabolic rate leads to a reduced ability to regulate body temperature. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism, where excess thyroid hormone leads to an increased sensitivity to heat. Increased appetite (Choice D) is not typically seen in hypothyroidism; instead, individuals with hypothyroidism may experience weight gain due to the slowed metabolism.

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