Nursing Elites

1. A nurse is caring for a client who has a new diagnosis of hypothyroidism. Which of the following findings should the nurse expect?

• A. Weight gain.
• B. Bradycardia.
• C. Tachycardia.
• D. Heat intolerance.

Correct answer: B

Rationale: The correct answer is B: Bradycardia. Bradycardia, or a slow heart rate, is a common finding in clients with hypothyroidism because of the decreased metabolic rate associated with this condition. Weight gain is also a common symptom of hypothyroidism due to the metabolic changes, making choice A incorrect. Tachycardia, or a rapid heart rate, is typically seen in hyperthyroidism, not hypothyroidism, so choice C is incorrect. Heat intolerance is more commonly associated with hyperthyroidism rather than hypothyroidism, making choice D incorrect.

2. A nurse is assessing a client who is receiving enteral feedings through a nasogastric tube. Which of the following findings requires immediate intervention?

• A. Aspirating 100 mL of gastric residual
• B. Gastric pH of 4
• C. Auscultating crackles in the lung bases
• D. Checking residual every 6 hours

Correct answer: C

Rationale: Auscultating crackles in the lung bases indicates fluid in the lungs, which can be a sign of aspiration pneumonia or pulmonary edema and requires immediate intervention to prevent respiratory distress. Aspirating 100 mL of gastric residual is within the acceptable range and does not require immediate intervention. A gastric pH of 4 is normal for gastric contents. Checking residual every 6 hours is a routine nursing intervention and does not indicate an urgent issue like pulmonary complications.

3. A nurse is caring for a client who has a new prescription for metformin. Which of the following instructions should the nurse include?

• A. Take this medication on an empty stomach.
• B. You should avoid eating foods high in potassium.
• C. You should take this medication with meals to improve absorption.
• D. Take this medication before bed to prevent drowsiness.

Correct answer: C

Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals to improve absorption and reduce gastrointestinal upset. Metformin is typically recommended to be taken with food to minimize side effects. Option A is incorrect as taking metformin on an empty stomach may increase the risk of gastrointestinal side effects. Option B is unrelated as metformin does not interact with potassium-rich foods. Option D is also incorrect as metformin does not cause drowsiness, so there is no need to take it before bed.

4. A healthcare provider is assessing a client who is receiving chemotherapy and reports mouth sores. Which of the following findings should the healthcare provider expect?

• A. Dry, cracked lips.
• B. Red, swollen gums.
• C. White patches on the tongue.
• D. Pale, dry mouth.

Correct answer: C

Rationale: White patches on the tongue are a sign of oral candidiasis, a common side effect of chemotherapy. This fungal infection can result in the development of white patches on the tongue. Dry, cracked lips (choice A) are more indicative of dehydration or lack of moisture. Red, swollen gums (choice B) may be a sign of gingivitis or periodontal disease. Pale, dry mouth (choice D) is not typically associated with mouth sores from chemotherapy.

5. A client is receiving discharge teaching regarding a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?

• A. I will eat more leafy green vegetables while taking warfarin.
• B. I will have my INR checked regularly while taking warfarin.
• C. I will avoid drinking grapefruit juice while taking warfarin.
• D. I will use a soft toothbrush while taking warfarin.

Correct answer: A

Rationale: The correct answer is A. Clients taking warfarin should avoid leafy green vegetables as they are high in vitamin K, which can reduce the effectiveness of the medication. Therefore, the statement 'I will eat more leafy green vegetables while taking warfarin' indicates a need for further teaching. Choice B is correct as regular monitoring of INR levels is necessary for clients on warfarin. Choice C is correct as grapefruit juice can interact with warfarin and should be avoided. Choice D is correct as using a soft toothbrush is recommended to prevent gum bleeding while on warfarin.

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