Nursing Elites

1. A nurse is assessing a client who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect?

• A. Constipation
• B. Absent deep-tendon reflexes
• C. Nausea and vomiting
• D. Tingling of the extremities

Correct answer: D

Rationale: Correct! A calcium level of 8.0 mg/dL indicates hypocalcemia. Hypocalcemia can lead to increased neuromuscular excitability, manifesting as tingling of the extremities. Choices A, B, and C are incorrect findings associated with other electrolyte imbalances or conditions and are not typically related to hypocalcemia. Constipation is commonly seen in hypokalemia, absent deep-tendon reflexes are associated with hypermagnesemia, and nausea and vomiting are more indicative of hypercalcemia.

2. A healthcare provider is assessing a client who has received a preoperative dose of morphine. Which of the following findings is the priority to report to the provider?

• A. Client reports nausea.
• B. Urinary output of 20 mL/hr.
• C. Oxygen saturation 90%.
• D. Respiratory rate 14/min.

Correct answer: C

Rationale: An oxygen saturation of 90% is below the expected reference range and could indicate respiratory depression, a serious side effect of morphine. This finding requires immediate attention as it may lead to hypoxia. Nausea (choice A) is a common side effect of morphine but does not pose an immediate threat. A urinary output of 20 mL/hr (choice B) may indicate decreased renal perfusion but is not as critical as respiratory compromise. A respiratory rate of 14/min (choice D) is within the normal range and does not suggest immediate danger.

3. How can a healthcare professional reduce the risk of falls in elderly patients?

• A. Encourage the use of assistive devices.
• B. Clear walkways.
• C. Ensure proper lighting.
• D. All of the above.

Correct answer: D

Rationale: All of these interventions are crucial in reducing the risk of falls in elderly patients. Encouraging the use of assistive devices helps provide support and stability, clearing walkways minimizes tripping hazards, and ensuring proper lighting enhances visibility and reduces the chances of falls. Therefore, choosing 'All of the above' is the most appropriate answer as each intervention plays a significant role in fall prevention.

4. A client with a peptic ulcer had a partial gastrectomy and vagotomy (Billroth I). In planning the discharge teaching, the client should be cautioned by the nurse about which of the following?

• A. Sit up for at least 30 minutes after eating
• B. Avoid fluids between meals
• C. Increase the intake of high-carbohydrate foods
• D. Avoid eating large meals that are high in simple sugars and liquids

Correct answer: D

Rationale: The correct answer is D: 'Avoid eating large meals that are high in simple sugars and liquids.' Clients who have undergone partial gastrectomy are at risk of dumping syndrome, which can occur due to the rapid emptying of stomach contents into the small intestine. Consuming large meals high in simple sugars and liquids can exacerbate this syndrome, leading to symptoms like abdominal cramping and diarrhea. Choices A, B, and C are not directly related to preventing dumping syndrome and are not the priority concerns for a client post-partial gastrectomy.

5. How should a healthcare provider assess and manage a patient with hyperthyroidism?

• A. Administer beta-blockers and monitor for signs of thyroid storm
• B. Encourage a high-protein, low-iodine diet
• C. Monitor for signs of bradycardia
• D. Provide iodine supplements and check for arrhythmias

Correct answer: A

Rationale: Administering beta-blockers is the initial management for hyperthyroidism to control symptoms such as tachycardia and tremors. Monitoring for signs of thyroid storm is crucial as it is a life-threatening complication of hyperthyroidism. Encouraging a high-protein, low-iodine diet (choice B) is not the primary intervention for managing hyperthyroidism. Monitoring for signs of bradycardia (choice C) is not typically seen in hyperthyroidism, as it often presents with tachycardia. Providing iodine supplements and checking for arrhythmias (choice D) are contraindicated in hyperthyroidism as they can worsen the condition.

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