Nursing Elites

1. A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings should the nurse report to the provider?

• A. Serum calcium level of 8 mg/dL.
• B. Urine output of 60 mL/hr.
• C. Heart rate of 110/min.
• D. Temperature of 37.5°C (99.5°F).

Correct answer: C

Rationale: The correct answer is C. A heart rate of 110/min is elevated and may indicate hypocalcemia, a potential complication following a thyroidectomy. Elevated heart rate can be a sign of hypocalcemia due to the close relationship between calcium levels and cardiac function. Option A, serum calcium level of 8 mg/dL, is within the normal range (8.5-10.5 mg/dL) and would not be a cause for concern post-thyroidectomy. Option B, urine output of 60 mL/hr, is within the normal range for urine output and not typically a priority finding post-thyroidectomy. Option D, a temperature of 37.5°C (99.5°F), is slightly elevated but not a critical finding post-thyroidectomy unless accompanied by other symptoms.

2. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?

• A. Serum potassium 4.0 mEq/L
• B. Sodium 138 mEq/L
• C. Serum creatinine 3.8 mg/dL
• D. Hemoglobin 13 g/dL

Correct answer: C

Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.

3. A nurse is teaching a client who has hypertension about managing blood pressure. Which of the following statements should the nurse make?

• A. Increase your intake of red meat to manage your blood pressure.
• B. You should avoid drinking alcohol while taking this medication.
• C. Exercise for at least 30 minutes most days of the week.
• D. Limit your fluid intake to 3 liters per day.

Correct answer: C

Rationale: The correct statement is C: 'Exercise for at least 30 minutes most days of the week.' Regular exercise is essential in managing blood pressure as it helps improve cardiovascular health. Choice A is incorrect as increasing red meat intake can be detrimental due to its high saturated fat content, which can negatively impact blood pressure. Choice B is not directly related to managing blood pressure unless the medication interacts negatively with alcohol. Choice D, limiting fluid intake to 3 liters per day, is not a general recommendation for managing blood pressure unless specifically advised by a healthcare provider.

4. A nurse is assessing a client who is experiencing acute pain. Which of the following manifestations should the nurse expect?

• A. Hypertension
• B. Bradycardia
• C. Diaphoresis
• D. Piloerection

Correct answer: C

Rationale: The correct answer is C: Diaphoresis. Diaphoresis, which is excessive sweating, is a common manifestation of acute pain caused by increased sympathetic nervous system activity. This response is the body's way of trying to regulate body temperature during the stress response. Choices A, B, and D are incorrect. Hypertension (Choice A) and tachycardia (not bradycardia as in Choice B) are more likely responses to acute pain due to sympathetic nervous system activation. Piloerection (Choice D), also known as goosebumps, is not a typical manifestation of acute pain.

5. A nurse is teaching a client who has chronic kidney disease about managing protein intake. Which of the following statements should the nurse include in the teaching?

• A. You should consume more plant-based protein.
• B. You should increase your intake of animal protein.
• C. You should increase your intake of high-protein foods.
• D. You should limit your intake of high-protein foods.

Correct answer: D

Rationale: The correct answer is D: "You should limit your intake of high-protein foods." Clients with chronic kidney disease should reduce their intake of high-protein foods to lessen the workload on the kidneys and prevent further kidney damage. Choices A, B, and C are incorrect because increasing intake of either plant-based or animal protein or high-protein foods can exacerbate kidney issues in individuals with chronic kidney disease.

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