Nursing Elites

1. A nurse is caring for a client prescribed prednisone. Which of the following should the nurse monitor?

• A. Blood glucose levels
• B. Serum potassium levels
• C. Liver function tests
• D. Heart rate

Correct answer: A

Rationale: Corrected Rationale: Prednisone is known to cause hyperglycemia by increasing blood glucose levels. Monitoring blood glucose levels is crucial to detect and manage any potential hyperglycemic effects of prednisone. While prednisone can also affect serum potassium levels and liver function, the priority monitoring parameter in this case is blood glucose levels. Monitoring heart rate is not directly associated with prednisone administration, making it a less relevant parameter to monitor in this scenario.

2. A client with diabetes mellitus is receiving education on foot care. Which of the following instructions should the nurse include?

• A. Apply lotion between the toes.
• B. Cut toenails straight across.
• C. Use a heating pad to warm the feet.
• D. Soak feet in warm water daily.

Correct answer: B

Rationale: The correct answer is B: Cut toenails straight across. This instruction is vital for clients with diabetes as it helps prevent ingrown toenails and infections, reducing the risk of foot ulcers. Applying lotion between the toes (choice A) should be avoided as it can create a moist environment prone to fungal infections. Using a heating pad (choice C) can lead to burns or injuries due to reduced sensation common in diabetes. Soaking feet in warm water daily (choice D) can also increase the risk of skin breakdown and should be avoided.

3. A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?

• A. Osteoporosis
• B. Scleroderma
• C. Asthma
• D. Peripheral vascular disease

Correct answer: A

Rationale: Clients with a history of osteoporosis should be carefully monitored when prescribed levothyroxine. Chronic overtreatment can cause increased bone loss, which raises the risk of fractures, especially in older adults. Thyroid hormone levels should be regularly monitored to avoid this complication. Scleroderma (choice B), asthma (choice C), and peripheral vascular disease (choice D) are not known to contraindicate the use of levothyroxine for hypothyroidism.

4. A nurse is assessing a client who had a stroke and is showing signs of dysphagia. Which finding indicates this condition?

• A. Abnormal mouth movements
• B. Inability to stand without assistance
• C. Paralysis of the right arm
• D. Loss of appetite

Correct answer: A

Rationale: Abnormal mouth movements are a key sign of dysphagia, a condition commonly seen in stroke clients. Dysphagia refers to difficulty swallowing, which can manifest as abnormal movements of the mouth during eating or drinking. In stroke patients, dysphagia increases the risk of aspiration, where food or liquids enter the airway instead of the esophagus, leading to potential complications such as pneumonia. Choices B, C, and D are not directly indicative of dysphagia. Inability to stand without assistance may indicate motor deficits, paralysis of the right arm suggests a neurological impairment, and loss of appetite can be a non-specific symptom in many conditions but does not specifically point to dysphagia.

5. A client with multiple sclerosis reports diplopia. Which of the following actions should the nurse take?

• A. Encourage the client to focus on a distant object.
• B. Apply a warm compress to the client’s eyes.
• C. Recommend alternating eye patches during the day.
• D. Administer artificial tears.

Correct answer: C

Rationale: The correct action for the nurse to take when caring for a client with multiple sclerosis reporting diplopia is to recommend alternating eye patches during the day. This strategy can help relieve diplopia (double vision) by allowing each eye to rest alternately, reducing eye strain. Encouraging the client to focus on a distant object (Choice A) is not an appropriate intervention for diplopia in this case. Applying a warm compress to the client's eyes (Choice B) and administering artificial tears (Choice D) are not effective interventions for diplopia associated with multiple sclerosis.

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