Nursing Elites

1. A nurse is caring for a patient postoperatively after a thyroidectomy. Which of the following findings should be reported immediately?

• A. Hoarseness
• B. Difficulty swallowing
• C. Numbness in the fingers
• D. Tingling around the mouth

Correct answer: D

Rationale: Tingling around the mouth should be reported immediately as it may indicate hypocalcemia, a serious complication resulting from accidental removal or damage to the parathyroid glands during thyroidectomy. Hoarseness and difficulty swallowing are common post-thyroidectomy symptoms related to the surgery itself and the manipulation of the vocal cords and nearby structures. Numbness in the fingers is not typically associated with immediate serious complications of a thyroidectomy.

2. Which nursing action will best promote patient safety when administering medications?

• A. Check the patient's wristband before administering medications.
• B. Confirm the patient's allergies prior to administration.
• C. Document the medications immediately after administration.
• D. Prepare medications at the medication cart to minimize distractions.

Correct answer: B

Rationale: Confirming the patient's allergies before administering medications is crucial for patient safety as it helps prevent adverse reactions. Checking the patient's wristband is important for identification but may not directly impact medication safety. Documenting medications after administration is necessary but does not primarily promote safety during administration. Preparing medications at the medication cart, rather than the nurse's station, is preferred to ensure accuracy and proper medication handling, but it is not directly related to confirming allergies for safety.

3. A healthcare professional suspects a colleague of diverting narcotics. What is the first step the healthcare professional should take?

• A. Confront the colleague directly
• B. Report the suspicion to the supervisor
• C. Ignore the issue and continue working
• D. Notify the pharmacy about the colleague's behavior

Correct answer: B

Rationale: The correct first step for a healthcare professional who suspects a colleague of diverting narcotics is to report the suspicion to the supervisor. This action is essential to protect patient safety, uphold ethical standards, and comply with legal obligations. Confronting the colleague directly may not only escalate the situation but also jeopardize the investigation process. Ignoring the issue and continuing to work could potentially harm patients and violate professional responsibilities. Notifying the pharmacy, while important, should come after informing the appropriate supervisor or authority within the healthcare facility.

4. When considering a bone marrow transplant for a client with leukemia, which ethical principle pertains to minimizing harm to the client?

• A. Justice
• B. Nonmaleficence
• C. Autonomy
• D. Beneficence

Correct answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the obligation to do no harm, making it crucial in medical decision-making. In the context of a bone marrow transplant for a client with leukemia, the primary concern is to minimize harm and avoid causing any unnecessary suffering or adverse effects. Choices A, C, and D are incorrect: Justice relates to fairness in resource allocation and treatment decisions, Autonomy involves respecting the patient's right to make decisions about their own care, and Beneficence refers to the obligation to act in the patient's best interest and promote their well-being, which may involve some level of risk or harm for overall benefit.

5. A nurse is teaching a client who has a new prescription for digoxin. Which of the following adverse effects should the nurse instruct the client to monitor and report to the provider?

• A. Increased appetite
• B. Rash on the face
• C. Yellow-tinged vision
• D. Weight gain

Correct answer: C

Rationale: The correct answer is C: 'Yellow-tinged vision.' Yellow-tinged vision is a characteristic sign of digoxin toxicity, indicating an overdose of the medication. This visual disturbance is a critical adverse effect that should be reported promptly to the healthcare provider to prevent serious complications.\n\nChoice A, 'Increased appetite,' is not typically associated with digoxin use and is not a common adverse effect.\n\nChoice B, 'Rash on the face,' is also not a common adverse effect of digoxin. Skin rash is not a typical manifestation of digoxin toxicity.\n\nChoice D, 'Weight gain,' is not a common adverse effect of digoxin. Weight gain is not a typical symptom of digoxin toxicity and is unlikely to be related to the medication.

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