Nursing Elites

1. A client is taking levothyroxine. Which of the following findings should indicate that the medication is effective?

• A. Weight loss
• B. Decreased blood pressure
• C. Absence of seizures
• D. Decreased inflammation

Correct answer: A

Rationale: The correct answer is A: Weight loss. Levothyroxine is used to treat hypothyroidism, which is characterized by symptoms such as weight gain. Therefore, weight loss in a client taking levothyroxine indicates that the medication is effective in managing hypothyroidism. Choices B, C, and D are incorrect because levothyroxine primarily affects thyroid function and metabolism, not blood pressure, seizures, or inflammation.

2. A healthcare professional is assessing a client with heart failure. Which of the following signs should the healthcare professional monitor for?

• A. Peripheral edema
• B. Tachycardia
• C. Bradycardia
• D. Hypotension

Correct answer: A

Rationale: In heart failure, the accumulation of fluid can lead to peripheral edema, which is swelling in the extremities. This is a common sign that healthcare professionals should monitor for. While tachycardia (increased heart rate), bradycardia (decreased heart rate), and hypotension (low blood pressure) can also occur in heart failure, they are not the primary signs typically associated with this condition. Therefore, peripheral edema is the most relevant sign to monitor in this case.

3. A nurse on an acute med-surgical unit is performing assessments on a group of clients. Which is the highest priority?

• A. Client with surgical hypoparathyroidism and positive Trousseau's sign
• B. Client with Clostridium difficile and acute diarrhea
• C. Client with acute kidney injury and low urine specific gravity
• D. Client with oral cancer and reports a sore on his gums

Correct answer: A

Rationale: The correct answer is A. A positive Trousseau's sign indicates hypocalcemia, which can lead to life-threatening complications like tetany or laryngospasm, making it the highest priority. Choices B, C, and D, while important, do not pose immediate life-threatening risks compared to the potential complications of severe hypocalcemia seen in a client with surgical hypoparathyroidism and a positive Trousseau's sign.

4. A nurse manager is teaching a group of employees about QSEN. What statement by an employee should the nurse manager identify as quality improvement?

• A. We should track the rate of hospital-acquired infections.
• B. We should evaluate patient satisfaction scores.
• C. We should start tracking how soon patients are discharged after laparoscopic versus open surgery.
• D. We should check the patient's temperature before discharge.

Correct answer: C

Rationale: The correct answer is C. QSEN focuses on quality improvement in healthcare. Tracking how soon patients are discharged after different types of surgeries helps in evaluating the quality of care provided and identifying areas for improvement. Choices A and B focus on monitoring outcomes but do not directly relate to quality improvement initiatives. Choice D is more about a routine assessment before discharge and does not involve a quality improvement process.

5. A nurse is assessing a client who has a femur fracture and is in skeletal traction. Which of the following findings should the nurse report to the provider?

• A. Clear fluid drainage from the pin sites
• B. Client reporting intermittent muscle spasms
• C. Client reporting severe pain despite receiving analgesics
• D. The traction weights are hanging freely

Correct answer: C

Rationale: The correct answer is C. Severe pain that is not relieved by analgesics may indicate neurovascular compromise or other complications and requires immediate attention by the provider. Choices A, B, and D are incorrect because clear fluid drainage from the pin sites is expected in skeletal traction, intermittent muscle spasms are common in this situation, and traction weights hanging freely indicate proper traction alignment.

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