Nursing Elites

1. A client has a new prescription for levothyroxine. What should the nurse teach the client?

• A. It should be taken at night
• B. Monitor for symptoms of hypothyroidism
• C. Take it with calcium supplements
• D. Take it on an empty stomach

Correct answer: D

Rationale: The correct answer is to take levothyroxine on an empty stomach. This is because levothyroxine should be taken in the morning on an empty stomach to ensure proper absorption. Option A is incorrect because levothyroxine is usually advised to be taken in the morning. Option B is not the priority teaching point as monitoring for hypothyroidism symptoms is ongoing care. Option C is incorrect as levothyroxine should not be taken with calcium supplements as they can interfere with its absorption.

2. A nurse overhears two assistive personnel (APs) discussing a client in a hospital cafeteria, using the client’s name and discussing details of the diagnosis. Which of the following actions should the nurse take first?

• A. Report the APs' behavior to the supervisor
• B. Complete an incident report regarding the APs' conversation
• C. Provide the APs with written documentation on confidentiality
• D. Tell the APs to discontinue their conversation

Correct answer: D

Rationale: The correct action for the nurse to take first is to tell the APs to discontinue their conversation. By stopping the conversation immediately, the nurse addresses the breach of client confidentiality on the spot. This action is crucial to protect the client's privacy and confidentiality. While further steps such as reporting the behavior or providing education on confidentiality may be necessary, the immediate priority is to stop the inappropriate discussion. Reporting the behavior to the supervisor or completing an incident report can come after the immediate issue is addressed. Providing written documentation on confidentiality may be helpful but is not the most urgent action needed in this situation.

3. A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the clients below?

• A. A client with glaucoma
• B. A client with renal failure
• C. A client with hypertension
• D. A client with insomnia

Correct answer: A

Rationale: Benzodiazepines can increase intraocular pressure, which is why they must be used cautiously in patients with glaucoma. In clients with this condition, benzodiazepines can potentially worsen symptoms and lead to further complications involving the eyes. Therefore, administering benzodiazepines to a client with glaucoma should be done with caution. Choices B, C, and D are not directly contraindicated with benzodiazepines, making them less likely to cause harm compared to administering to a client with glaucoma.

4. 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.

5. A nurse is teaching about measures to promote sleep with insomnia. What statement indicates understanding?

• A. Take naps throughout the day
• B. Reduce fluid intake 2 hours before bedtime
• C. Drink coffee to help stay awake
• D. Increase screen time before bed

Correct answer: B

Rationale: The correct answer is B. Reducing fluid intake before bedtime helps prevent interruptions in sleep due to bathroom visits, which is crucial for individuals with insomnia. Taking naps throughout the day (choice A) may disrupt nighttime sleep. Drinking coffee (choice C) is counterproductive as it contains caffeine, which can interfere with falling asleep. Increasing screen time before bed (choice D) can negatively impact sleep quality due to the stimulating effects of screens.

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