Nursing Elites

1. A client has a new diagnosis of hypothyroidism. Which of the following interventions should the nurse include in the plan of care?

• A. Provide a high-calorie diet.
• B. Encourage frequent rest periods.
• C. Restrict fluid intake.
• D. Increase iodine intake.

Correct answer: B

Rationale: The correct intervention for a client with hypothyroidism is to encourage frequent rest periods. Hypothyroidism often leads to fatigue, making rest essential for recovery and symptom management. Providing a high-calorie diet is not necessary unless the client has gained weight due to hypothyroidism. Restricting fluid intake is not indicated unless there are specific medical reasons for it. Increasing iodine intake is not recommended for primary hypothyroidism, as it is typically caused by autoimmune thyroiditis or other factors rather than iodine deficiency.

2. During an assessment, a healthcare professional observes significant tenting of the skin over an older adult client's forearm. What factor should the healthcare professional primarily consider as a cause for this finding?

• A. Thin, parchment-like skin
• B. Loss of adipose tissue
• C. Dehydration
• D. Diminished skin elasticity

Correct answer: C

Rationale: Dehydration is the primary factor to consider in this scenario. Dehydration leads to decreased skin turgor and tenting, where the skin does not return to its normal position when pinched. While thin, parchment-like skin, loss of adipose tissue, and diminished skin elasticity can contribute to skin changes, they are not the primary cause of the significant tenting observed.

3. Which anatomical location is associated with the deep tendon reflex known as the patellar reflex?

• A. Knee picture
• B. Ankle picture
• C. Elbow picture
• D. Wrist picture

Correct answer: A

Rationale: The patellar reflex, also called the knee-jerk reflex, is elicited by tapping the patellar tendon just below the patella. This reflex involves the quadriceps muscle and the femoral nerve. The correct answer is 'A: Knee picture' because the patellar reflex is associated with the knee joint. Choices B, C, and D are incorrect as they do not correspond to the anatomical location involved in the patellar reflex.

4. The healthcare provider is caring for a client receiving total parenteral nutrition (TPN). Which laboratory value should be monitored closely to assess for complications?

• A. Serum sodium
• B. Serum calcium
• C. Blood urea nitrogen (BUN)
• D. Blood glucose

Correct answer: D

Rationale: The correct answer is D: Blood glucose. Monitoring blood glucose levels is crucial for clients receiving total parenteral nutrition (TPN) due to the high glucose content in TPN solutions. TPN delivers essential nutrients, including glucose, directly into the bloodstream. Clients on TPN are at risk of developing hyperglycemia due to the concentrated glucose infusion. Therefore, close monitoring of blood glucose levels is necessary to detect and prevent hyperglycemia-related complications such as osmotic diuresis, hyperosmolarity, and electrolyte imbalances. While serum sodium, serum calcium, and blood urea nitrogen (BUN) levels are important parameters in various clinical scenarios, they are not specifically associated with TPN administration. These values are not the primary indicators to assess for complications in clients receiving TPN.

5. A nurse prepares an injection of morphine to administer to a client who reports pain but asks a second nurse to give the injection because another assigned client needs to use a bedpan. Which of the following actions should the second nurse take?

• A. Offer to assist the client who needs the bedpan.
• B. Administer the injection the other nurse prepared.
• C. Prepare another syringe and administer the injection.
• D. Tell the client who needs the bedpan to wait while the nurse gives someone else medication.

Correct answer: C

Rationale: The second nurse should prepare a new syringe and administer the medication to ensure proper and timely pain management. Administering another nurse's medication without preparation could lead to errors. Choice A is not the priority as the medication administration should take precedence. Choice B is not recommended as the second nurse should not administer medication prepared by another nurse. Choice D is inappropriate as patient needs should not be compromised for medication administration to another client.

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