Nursing Elites

1. A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which action should the nurse take?

• A. Massage the affected extremity
• B. Elevate the affected leg
• C. Apply cold packs to the affected leg
• D. Keep the leg dependent to increase circulation

Correct answer: B

Rationale: Elevating the leg promotes venous return and reduces swelling, which is crucial for clients with DVT. Massaging the affected extremity can dislodge the clot and worsen the condition. Applying cold packs can cause vasoconstriction, potentially increasing the risk of clot formation. Keeping the leg dependent can impede circulation and increase the risk of clot migration.

2. A client who is 32 weeks pregnant and has a diagnosis of placenta previa is receiving teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit physical activity
• B. Monitor fetal movements daily
• C. Call the healthcare provider if contractions begin
• D. All of the above

Correct answer: D

Rationale: Clients diagnosed with placenta previa are at an increased risk of bleeding and preterm labor. Therefore, it is essential for them to limit physical activity to prevent complications. Monitoring fetal movements daily helps in assessing the well-being of the fetus. Additionally, notifying the healthcare provider if contractions begin is crucial as it could be a sign of preterm labor. Therefore, all of the instructions (limiting physical activity, monitoring fetal movements, and calling the healthcare provider if contractions begin) are necessary for managing placenta previa effectively. Choices A, B, and C are all correct instructions for a client with placenta previa.

3. A healthcare provider is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone (TSH) level and a decreased total T3 and T4 level. The healthcare provider should anticipate a prescription for which of the following medications?

• A. Methimazole
• B. Somatropin
• C. Levothyroxine
• D. Propylthiouracil

Correct answer: C

Rationale: The client’s symptoms and lab results indicate hypothyroidism, and levothyroxine is the standard treatment to replace the deficient thyroid hormones. Methimazole and propylthiouracil are used to treat hyperthyroidism by decreasing the production of thyroid hormones. Somatropin is a growth hormone used in conditions of growth hormone deficiency, not for hypothyroidism.

4. A nurse is caring for a client with a history of substance abuse. Which of the following interventions should the nurse prioritize?

• A. Monitor for withdrawal symptoms
• B. Encourage social activities
• C. Schedule regular follow-ups
• D. Provide educational materials

Correct answer: A

Rationale: The correct answer is to monitor for withdrawal symptoms. This is a priority because individuals with a history of substance abuse are at risk of experiencing withdrawal symptoms when the substance is no longer used. Monitoring for withdrawal symptoms is crucial to ensure the client's safety and to manage any potential complications related to substance withdrawal. Encouraging social activities, scheduling regular follow-ups, and providing educational materials are also important aspects of care, but they are not as critical as monitoring for withdrawal symptoms in this immediate scenario.

5. A nurse is caring for a client with a new prescription for clindamycin. Which of the following should the nurse monitor?

• A. Liver function
• B. Serum potassium
• C. Signs of superinfection
• D. Blood glucose

Correct answer: C

Rationale: The correct answer is C: Signs of superinfection. Clindamycin can lead to antibiotic-associated colitis and other superinfections, making it crucial for the nurse to monitor the client for signs of superinfection. Monitoring liver function (choice A) is not typically associated with clindamycin use. Serum potassium levels (choice B) and blood glucose (choice D) are also not directly affected by clindamycin, so they are not the priority for monitoring in this case.

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