Nursing Elites

1. A nurse is caring for a client who is taking digoxin. Which of the following findings should the nurse identify as a sign of digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Hypotension
• D. Hyperkalemia

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a cardiac glycoside, can lead to toxicity manifesting as bradycardia due to its effect on the heart's electrical conduction system. Tachycardia (choice B) is not typically associated with digoxin toxicity. Hypotension (choice C) and hyperkalemia (choice D) are not direct signs of digoxin toxicity. Therefore, the correct answer is bradycardia.

2. A nurse is caring for a client who is postoperative following a thyroidectomy and reports tingling and numbness in the hands. The nurse should expect to administer which of the following medications?

• A. Sodium bicarbonate.
• B. Calcium gluconate.
• C. Potassium chloride.
• D. Magnesium sulfate.

Correct answer: B

Rationale: Tingling and numbness in the hands can indicate hypocalcemia, a common complication following a thyroidectomy. Hypocalcemia requires immediate intervention to prevent severe complications like tetany and seizures. Calcium gluconate is the drug of choice for rapidly raising serum calcium levels in hypocalcemic patients. Sodium bicarbonate is not indicated for treating hypocalcemia or related symptoms. Potassium chloride is used to correct potassium imbalances, not calcium. Magnesium sulfate is not the appropriate treatment for hypocalcemia; it is commonly used for conditions like preeclampsia or eclampsia.

3. What are the early signs of sepsis in a patient?

• A. Increased heart rate and fever
• B. Low blood pressure and confusion
• C. Elevated blood sugar and sweating
• D. Increased urine output and abdominal pain

Correct answer: A

Rationale: The correct answer is A: Increased heart rate and fever. These are early signs of sepsis and indicate a systemic infection. It is crucial to identify these signs promptly to initiate appropriate treatment. Choice B is incorrect because low blood pressure and confusion are more indicative of severe sepsis or septic shock rather than early signs. Choice C is incorrect as elevated blood sugar and sweating are not typical early signs of sepsis. Choice D is also incorrect as increased urine output and abdominal pain are not early signs of sepsis.

4. A client with multiple fractures following a motor-vehicle crash is struggling with opening a milk carton. Which of the following client statements should the nurse recommend a referral to an occupational therapist?

• A. I can't brush my teeth properly
• B. I am so frustrated I can't open my milk carton
• C. I can't hold a pencil
• D. I can't write anymore

Correct answer: B

Rationale: The correct answer is B. Struggling to open a milk carton indicates difficulty with fine motor skills and activities of daily living. This statement suggests a need for assistance from an occupational therapist to improve hand strength, coordination, and independence in performing essential tasks. Choices A, C, and D do not directly relate to the need for occupational therapy services in this context. In contrast, the inability to open a milk carton highlights specific challenges that occupational therapy can address effectively.

5. What are the complications of untreated hypertension?

• A. Heart disease and stroke
• B. Kidney failure and vision loss
• C. Pulmonary embolism and arrhythmias
• D. Blood clots and gastrointestinal bleeding

Correct answer: A

Rationale: The correct answer is A: 'Heart disease and stroke.' Untreated hypertension can lead to various complications, including heart disease and stroke. These are common outcomes of long-term high blood pressure. Choice B, 'Kidney failure and vision loss,' is incorrect as kidney failure and vision loss are more commonly associated with diabetic complications rather than untreated hypertension. Choice C, 'Pulmonary embolism and arrhythmias,' while serious, are not among the primary complications of untreated hypertension. Choice D, 'Blood clots and gastrointestinal bleeding,' are not typical complications of untreated hypertension but can occur due to other conditions such as blood clotting disorders or gastrointestinal diseases.

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