Nursing Elites

1. A nurse is planning a staff education program to review nursing interventions for clients who have kidney failure. Which of the following sources should the nurse identify as the best resource for obtaining evidence-based information?

• A. The advice of an expert nephrology nurse
• B. Retrospective chart reviews
• C. Facility critical pathway
• D. A recent peer-reviewed nursing research article

Correct answer: D

Rationale: A peer-reviewed nursing research article is the best resource for obtaining evidence-based information because it provides the most current and reliable data on nursing interventions. Choice A, the advice of an expert nephrology nurse, may be helpful but could be based on individual experience rather than the latest research. Retrospective chart reviews (Choice B) focus on past cases and may not reflect current best practices. Facility critical pathways (Choice C) offer standardized care plans but may not always incorporate the most up-to-date evidence-based practices.

2. A nurse is caring for a client who had a total thyroidectomy and has a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

• A. Shortened QT intervals
• B. Hypoactive deep tendon reflexes
• C. Tingling of the extremities
• D. Constipation

Correct answer: C

Rationale: The correct answer is C: Tingling of the extremities. Tingling is a common symptom of hypocalcemia, which is expected with low calcium levels after a thyroidectomy. Option A, shortened QT intervals, is associated with hypercalcemia rather than hypocalcemia. Option B, hypoactive deep tendon reflexes, is not typically related to hypocalcemia. Option D, constipation, is not a common finding associated with low calcium levels.

3. A patient with heart failure needs education on fluid restrictions. What is the most important information to provide?

• A. Monitor the patient's weight daily.
• B. Provide the patient with a fluid restriction plan.
• C. Instruct the patient to avoid salty foods.
• D. Encourage the patient to increase fluid intake.

Correct answer: B

Rationale: The most important information to provide to a patient with heart failure regarding fluid restrictions is to provide them with a fluid restriction plan. This plan helps the patient manage their fluid intake effectively, which is crucial in preventing complications associated with heart failure. Monitoring weight daily can be a part of the plan but is not the most important. Instructing the patient to avoid salty foods is beneficial but not as crucial as having a structured fluid restriction plan. Encouraging the patient to increase fluid intake would be counterproductive and potentially harmful in a patient with heart failure.

4. A client with a history of falls is under the care of a nurse. Which intervention is most important to implement?

• A. Increase the frequency of bed checks.
• B. Use bed alarms to prevent falls.
• C. Keep the room well lit during the day.
• D. Encourage the client to use a walker for mobility.

Correct answer: B

Rationale: Using bed alarms to prevent falls is the most important intervention to implement for a client with a history of falls. Bed alarms can provide timely alerts to the healthcare team, allowing for quick assistance to prevent falls. Increasing the frequency of bed checks may not necessarily prevent falls as effectively as direct intervention with bed alarms. Keeping the room well lit is important for general safety but may not address the immediate risk of falls. Encouraging the client to use a walker for mobility is beneficial but may not be as crucial as implementing bed alarms to prevent falls in this scenario.

5. A client undergoing chemotherapy expresses concern about hair loss. What should the nurse suggest?

• A. Encourage the client to cut their hair short before chemotherapy.
• B. Provide resources for wigs or hairpieces.
• C. Assure the client that hair loss will be minimal.
• D. Offer the client medication to reduce the chances of hair loss.

Correct answer: B

Rationale: The correct answer is B: Providing wigs and other coping resources helps clients manage the emotional effects of chemotherapy-related hair loss. Encouraging the client to cut their hair short before chemotherapy (Choice A) is not necessary as hair loss may still occur. Assuring the client that hair loss will be minimal (Choice C) may provide false hope as hair loss is a common side effect of chemotherapy. Offering medication to reduce hair loss (Choice D) is not a typical approach as chemotherapy-related hair loss is often an expected side effect that cannot be entirely prevented with medication.

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