Nursing Elites

1. A nurse is caring for a client who is scheduled for surgery in the morning. The nurse learns that the client has decided not to have surgery even though they have already signed the informed consent form. Which of the following actions should the nurse take?

• A. Ignore the client's decision and proceed
• B. Report the situation to the provider
• C. Ask the family to convince the client
• D. Reassess the need for surgery with the client

Correct answer: B

Rationale: The correct action for the nurse to take is to report the client's decision to the provider who obtained informed consent. This ensures that the provider is informed of the client's change in decision and can discuss the situation further with the client. Choice A is incorrect as ignoring the client's decision is not appropriate and goes against the principles of patient autonomy. Choice C is incorrect because involving the family in convincing the client can be coercive and may not respect the client's autonomy. Choice D is incorrect because the nurse should not re-sign the informed consent form without the client's consent and a discussion with the provider.

2. A client with a tracheostomy is experiencing increased secretions and labored breathing. What should the nurse do first?

• A. Administer a bronchodilator
• B. Suction the tracheostomy
• C. Encourage the client to cough
• D. Notify the provider

Correct answer: B

Rationale: The correct answer is to suction the tracheostomy first. When a client with a tracheostomy is experiencing increased secretions and labored breathing, suctioning the tracheostomy is the priority intervention to clear the airway and improve breathing. Administering a bronchodilator (Choice A) may help with breathing but should come after ensuring the airway is clear. Encouraging the client to cough (Choice C) may not be effective in clearing secretions from the tracheostomy. Notifying the provider (Choice D) can be done after ensuring immediate airway clearance.

3. How should a healthcare professional assess a patient with suspected deep vein thrombosis (DVT)?

• A. Monitor for leg pain, swelling, and redness
• B. Check for calf tenderness and administer anticoagulants
• C. Check for discoloration and monitor oxygen saturation
• D. Check for numbness and provide thrombolytic therapy

Correct answer: A

Rationale: Correct Answer: The correct way to assess a patient with suspected deep vein thrombosis (DVT) is to monitor for leg pain, swelling, and redness. These are common clinical manifestations of DVT. Choice B is incorrect because administering anticoagulants should be based on a confirmed diagnosis, not just suspicion. Choice C is incorrect because discoloration and oxygen saturation are not primary indicators of DVT. Choice D is incorrect because numbness is not a typical symptom of DVT, and thrombolytic therapy is not the first-line treatment for suspected DVT.

4. What are the signs and symptoms of Cushing's syndrome, and how should they be managed?

• A. Weight gain, moon face; administer corticosteroids
• B. Hirsutism and thin extremities; manage with diuretics
• C. Purple striae, muscle weakness; provide dietary counseling
• D. Hypertension and bruising; manage with fluid restriction

Correct answer: A

Rationale: The correct signs and symptoms of Cushing's syndrome are weight gain and a moon face. Corticosteroids are used to manage Cushing's syndrome by reducing the overproduction of cortisol. Choice B is incorrect because hirsutism and thin extremities are not typical signs of Cushing's syndrome. Choice C is incorrect as purple striae and muscle weakness are more characteristic of the syndrome. Choice D is also incorrect as hypertension and bruising are not primary signs of Cushing's syndrome.

5. A client with active tuberculosis is receiving discharge instructions. Which statement by the client indicates an understanding of the teaching?

• A. I will continue taking my isoniazid until I am no longer contagious.
• B. I should take my prescribed medication for at least 6 months.
• C. I will need to have a TB skin test every 3 months.
• D. I should wear a mask at all times.

Correct answer: B

Rationale: The correct answer is B because the client should take antitubercular medications for a minimum of 6 months to ensure complete eradication of the infection. Choice A is incorrect as stopping the medication early can result in treatment failure and development of drug-resistant TB. Choice C is incorrect as regular TB skin tests are not needed once the client has been diagnosed and treated. Choice D is incorrect as wearing a mask at all times is not necessary for a client with active TB; proper cough etiquette should be followed instead.

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