Nursing Elites

1. A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should monitor for which of the following findings as a sign of hypocalcemia?

• A. Nausea
• B. Tingling in the fingers
• C. Numbness in the toes
• D. Sweating

Correct answer: B

Rationale: Tingling in the fingers is a classic sign of hypocalcemia. Following a thyroidectomy, hypocalcemia can occur due to damage to the parathyroid glands, which regulate calcium levels in the body. Nausea, numbness in the toes, and sweating are not specific signs of hypocalcemia. Numbness and tingling usually start in the hands and feet due to their increased nerve sensitivity to low calcium levels.

2. A nurse in a long-term care facility is reviewing information about health care-associated infections with a newly licensed nurse. Which of the following information should the nurse include?

• A. Frequent hand washing prevents infection
• B. Prolonged use of corticosteroids increases infection risk
• C. Limit patient interaction to reduce infection spread
• D. Restrict client movement to prevent contamination

Correct answer: B

Rationale: The correct answer is B because prolonged use of corticosteroids is a known risk factor for infections. Choice A is incorrect because frequent hand washing actually helps prevent infections. Choice C is incorrect as patient interaction is essential in healthcare but should be done following proper infection control measures. Choice D is also incorrect as restricting client movement is not a standard practice to prevent contamination.

3. A client who is 1 day postoperative following a total hip arthroplasty should be instructed to do which of the following?

• A. Avoid using a walker while walking.
• B. Keep the hip flexed at 90° while sitting.
• C. Place a pillow between your legs when turning.
• D. Cross your legs at the ankles when sitting.

Correct answer: C

Rationale: Placing a pillow between the legs is essential post-total hip arthroplasty to prevent adduction of the hip joint, reducing the risk of dislocation. Choices A, B, and D are incorrect. Using a walker while walking is encouraged for support and stability. Keeping the hip flexed at 90° while sitting can increase the risk of hip dislocation. Crossing legs at the ankles when sitting may also lead to hip dislocation.

4. What are the early signs of a pulmonary embolism?

• A. Chest pain, shortness of breath, and tachycardia
• B. Fever, nausea, and vomiting
• C. Cough, cyanosis, and fatigue
• D. Abdominal pain and bradycardia

Correct answer: A

Rationale: The correct answer is A: Chest pain, shortness of breath, and tachycardia. These are classic early signs of a pulmonary embolism. Chest pain may be sudden and sharp, worsened by deep breathing or coughing. Shortness of breath can be sudden and severe. Tachycardia (rapid heart rate) is another common symptom. Choices B, C, and D are incorrect as they do not represent typical early signs of a pulmonary embolism.

5. A nurse is teaching a client how to administer enoxaparin. Which of the following instructions should the nurse include?

• A. Inject the medication into the muscle of the thigh
• B. Massage the injection site after administration
• C. Pinch the skin before injecting
• D. Administer the medication at the same time each day

Correct answer: C

Rationale: The correct instruction for administering enoxaparin is to pinch the skin before injecting. Pinching the skin helps create a proper fold for subcutaneous injections like enoxaparin, ensuring proper delivery of the medication into the subcutaneous tissue. Choice A is incorrect because enoxaparin should be administered subcutaneously, not into the muscle. Injecting it into the muscle can lead to complications. Choice B is incorrect because massaging the injection site after administration can increase the risk of bleeding or bruising due to the anticoagulant properties of enoxaparin. Choice D is incorrect as it is a general instruction and does not specifically relate to the administration of enoxaparin.

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