Nursing Elites

1. A healthcare professional is assessing a client who is experiencing a thyroid storm. Which of the following is an expected finding?

• A. Hypothermia
• B. Bradycardia
• C. Hypertension
• D. Lethargy

Correct answer: C

Rationale: In a thyroid storm, which is a severe complication of hyperthyroidism, hypertension is an expected finding. Other common manifestations include tachycardia, hyperthermia, and agitation. Hypothermia (choice A) is not expected in a thyroid storm as the body temperature is usually elevated due to increased metabolic rate. Bradycardia (choice B) is not typical in a thyroid storm; instead, tachycardia is more common. Lethargy (choice D) is not a typical finding in a thyroid storm, as clients are usually agitated due to excess thyroid hormone levels.

2. A nurse is caring for a client who is 8 hours postpartum following a vaginal birth. The client reports passing large clots and heavy bleeding. Which of the following actions should the nurse take?

• A. Massage the fundus
• B. Administer methylergonovine
• C. Increase the IV fluid rate
• D. Notify the healthcare provider

Correct answer: A

Rationale: Heavy bleeding and the passage of large clots after childbirth can indicate uterine atony. The nurse should first attempt to massage the fundus to stimulate uterine contractions and control the bleeding. Massaging the fundus helps the uterus to contract and may help prevent further bleeding. Administering methylergonovine (Choice B) is not the initial intervention for uterine atony. Increasing the IV fluid rate (Choice C) may not address the underlying cause of the bleeding. Notifying the healthcare provider (Choice D) can be done after attempting initial interventions like fundal massage.

3. A healthcare provider is preparing to administer a vaccine to a child. Which of the following should the provider verify?

• A. Allergy to eggs
• B. Previous vaccination history
• C. Family medical history
• D. Growth charts

Correct answer: B

Rationale: The healthcare provider should verify the child's previous vaccination history to ensure they are up to date with immunizations. This is important to prevent unnecessary or duplicate vaccinations and ensure the child is adequately protected against vaccine-preventable diseases. Checking for allergies to eggs is relevant for certain vaccines like the influenza vaccine but is not the top priority in this scenario. Family medical history and growth charts are not directly related to the administration of vaccines and are not as crucial as confirming the child's vaccination status.

4. A home care nurse is following up with a postpartum client. Which of the following is a risk factor that places this client at risk for postpartum depression?

• A. History of anxiety
• B. Socioeconomic status
• C. Hormonal changes with a rapid decline in estrogen and progesterone
• D. Support from family members

Correct answer: C

Rationale: Postpartum depression can be triggered by various factors, but one of the strongest predictors is a rapid drop in estrogen and progesterone levels following childbirth. These hormonal changes can affect mood regulation, making some women more vulnerable to depression during the postpartum period. Choices A, B, and D are not direct risk factors associated with postpartum depression. While a history of anxiety may contribute, it is not as directly linked to the hormonal changes that occur postpartum. Socioeconomic status and support from family members may influence the overall well-being of the mother but are not specific risk factors for postpartum depression.

5. A nurse is providing discharge instructions for a client after surgery. Which of the following should be included?

• A. Resume normal activities immediately
• B. Monitor for signs of infection
• C. Avoid all physical activity for 1 month
• D. Take pain medications only as needed

Correct answer: B

Rationale: The correct answer is B: 'Monitor for signs of infection.' After surgery, it is essential for clients to watch for signs of infection, such as increased redness, swelling, or drainage at the incision site. Choice A is incorrect because resuming normal activities immediately after surgery can be harmful. Choice C is incorrect as complete avoidance of physical activity for a month is typically not necessary and can lead to complications like blood clots. Choice D is incorrect as taking pain medications only as needed may not provide adequate pain management post-surgery.

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