Nursing Elites

1. A client is postoperative following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypocalcemia?

• A. Constipation
• B. Numbness and tingling of the fingers
• C. Increased thirst
• D. Frequent urination

Correct answer: B

Rationale: Numbness and tingling of the fingers are classic signs of hypocalcemia, a condition that may result from inadvertent damage to the parathyroid glands during a thyroidectomy. These symptoms occur due to decreased levels of calcium in the bloodstream affecting nerve function. Choices A, C, and D are not typical manifestations of hypocalcemia. Constipation is more associated with hypercalcemia, increased thirst can be seen in diabetes or dehydration, and frequent urination is a symptom more commonly linked to conditions like diabetes or urinary tract issues.

2. A nurse is caring for a client who has chronic kidney disease and a serum potassium level of 6.0 mEq/L. Which of the following findings should the nurse expect?

• A. Hypokalemia
• B. Hypocalcemia
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: D

Rationale: The correct answer is D: Hyperkalemia. In chronic kidney disease, there is decreased renal excretion of potassium, leading to elevated serum potassium levels. Hypokalemia (Choice A) is low potassium levels, which is the opposite finding in this scenario. Hypocalcemia (Choice B) is decreased calcium levels and is not directly related to chronic kidney disease or elevated potassium levels. Hypoglycemia (Choice C) is low blood sugar levels and is not typically associated with chronic kidney disease or high potassium levels.

3. What is the initial nursing action for a patient presenting with chest pain?

• A. Administer aspirin
• B. Reposition the patient
• C. Provide pain relief
• D. Prepare for surgery

Correct answer: A

Rationale: The correct initial nursing action for a patient presenting with chest pain is to administer aspirin. Aspirin helps reduce the risk of further clot formation in patients experiencing chest pain, as it has antiplatelet effects. Repositioning the patient, providing pain relief, or preparing for surgery are not the first-line interventions for chest pain. Repositioning the patient may be necessary to ensure comfort and safety, pain relief can be provided after further assessment and diagnostic tests, and preparing for surgery would only be considered after a thorough evaluation and confirmation of the need for surgical intervention.

4. A nurse is caring for a client who is 4 hours postoperative following an open cholecystectomy. Which of the following actions should the nurse take?

• A. Monitor the client's urinary output.
• B. Assist the client to splint the incision with a pillow when coughing.
• C. Provide the client with a clear liquid diet.
• D. Encourage the client to ambulate in the hallway.

Correct answer: B

Rationale: Assisting the client to splint the incision with a pillow while coughing is the correct action in this scenario. This intervention helps reduce pain and prevent wound dehiscence, which is the partial or complete separation of the layers of a surgical wound. Monitoring urinary output is important but not the priority at this immediate postoperative stage. Providing a clear liquid diet may be indicated later but is not the most immediate concern. Encouraging ambulation is beneficial for preventing complications like deep vein thrombosis, but splinting the incision is more crucial at this early postoperative period.

5. A nurse is providing dietary teaching to a client who has a new diagnosis of chronic kidney disease. Which of the following foods should the nurse instruct the client to avoid?

• A. Baked chicken
• B. Bananas
• C. Lean cuts of beef
• D. Canned soup

Correct answer: D

Rationale: The correct answer is D: Canned soup. Canned soups are typically high in sodium, which can lead to fluid retention in clients with chronic kidney disease. Sodium restriction is crucial in managing this condition. Choice A, baked chicken, is a lean protein source that is generally recommended for individuals with kidney disease. Bananas (Choice B) are high in potassium, so clients with kidney disease may need to limit their intake depending on their individual treatment plan. Lean cuts of beef (Choice C) can be a good source of protein and iron for clients with kidney disease as long as portion sizes are controlled to manage protein intake.

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