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. What is the most important action when providing wound care to a client with a pressure ulcer?

• A. Apply a dry, sterile dressing to the wound
• B. Cleanse the wound with normal saline
• C. Perform a wound culture before applying ointment
• D. Cover the wound with a wet-to-dry dressing

Correct answer: C

Rationale: Performing a wound culture before applying ointment is crucial when providing wound care to a client with a pressure ulcer. This action helps identify any underlying infections, allowing healthcare providers to select the most appropriate treatment. Options A, B, and D are not as critical as performing a wound culture, as they focus on wound dressing and cleansing rather than identifying potential infections.

3. A nurse is caring for a client following an acute myocardial infarction who is concerned about fatigue. What is the best strategy to promote independence in self-care?

• A. Instruct the client to remain in bed until the fatigue resolves
• B. Encourage the client to gradually resume self-care tasks with frequent rest periods
• C. Assign assistive personnel to perform all self-care tasks for the client
• D. Ask the client's family to assist with self-care

Correct answer: B

Rationale: Encouraging the client to gradually resume self-care tasks with frequent rest periods is the best strategy to promote independence while managing fatigue. This approach allows the client to regain confidence in their abilities and fosters independence. Option A is incorrect as prolonged bed rest can lead to deconditioning and worsen fatigue. Option C is not promoting independence as it involves delegating all self-care tasks to others. Option D involves family assistance, which may be helpful but does not directly promote the client's independence in self-care.

4. Which of the following is a key consideration when providing wound care for a client with a pressure ulcer?

• A. Cover the wound with a dry, sterile dressing
• B. Perform a wound culture before applying ointment
• C. Cleanse the wound with alcohol
• D. Cover the wound with a wet-to-dry dressing

Correct answer: B

Rationale: Performing a wound culture before applying ointment is crucial when providing wound care for a client with a pressure ulcer. This step helps identify the presence of any infection, allowing for appropriate treatment. Choice A is incorrect because covering the wound with a dry, sterile dressing may not address potential infections. Choice C is incorrect as cleansing the wound with alcohol can be too harsh and drying to the surrounding skin. Choice D is incorrect because covering the wound with a wet-to-dry dressing is not typically recommended for pressure ulcers, as it can cause trauma to the wound bed during removal.

5. What are the key differences between systolic and diastolic heart failure?

• A. Systolic: Reduced ejection fraction; Diastolic: Preserved ejection fraction
• B. Systolic: Preserved ejection fraction; Diastolic: Reduced ejection fraction
• C. Systolic: Right-sided heart failure; Diastolic: Left-sided heart failure
• D. Systolic: Pulmonary congestion; Diastolic: Systemic congestion

Correct answer: A

Rationale: The correct answer is A. Systolic heart failure is characterized by reduced ejection fraction, meaning the heart is not pumping effectively. Diastolic heart failure, on the other hand, is characterized by preserved ejection fraction, indicating that the heart has difficulty relaxing and filling properly. Choices B, C, and D are incorrect because they do not accurately describe the key differences between systolic and diastolic heart failure.

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