Nursing Elites

1. A client who has a new prescription for levothyroxine is receiving teaching from a nurse. Which statement by the client indicates an understanding of the teaching?

• A. I will need to take this medication for 3 months.
• B. I will take this medication with an antacid.
• C. I will avoid foods that contain iodine.
• D. I will take this medication in the morning before breakfast.

Correct answer: D

Rationale: The correct answer is D: "I will take this medication in the morning before breakfast." Levothyroxine should be taken in the morning before breakfast to improve absorption and effectiveness. Choice A is incorrect because the duration of levothyroxine therapy is usually long-term and not limited to 3 months. Choice B is incorrect because levothyroxine should not be taken with antacids as they may decrease its absorption. Choice C is incorrect because there is no need to avoid foods that contain iodine while taking levothyroxine.

2. A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse expect?

• A. Increased urine output
• B. Increased serum sodium
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: C

Rationale: In clients with Syndrome of Inappropriate Antidiuretic Hormone (SIADH), the nurse should expect hyponatremia. SIADH leads to excess water retention, diluting the sodium levels in the blood, resulting in low serum sodium levels. Choice A, increased urine output, is incorrect as SIADH causes water retention, leading to decreased urine output. Choice B, increased serum sodium, is incorrect because SIADH causes a dilutional effect due to water retention, resulting in decreased serum sodium levels. Choice D, hypercalcemia, is unrelated to SIADH and not a typical finding.

3. A nurse is assessing a client who is 4 hours postpartum. Which of the following findings should the nurse report to the provider?

• A. Lochia that is red and contains small clots.
• B. Fundus firm at the umbilicus.
• C. Fundus deviated to the right.
• D. Moderate perineal pain with swelling.

Correct answer: C

Rationale: The correct answer is C. A fundus that is deviated to the right may indicate a full bladder, which should be addressed postpartum. Choice A is incorrect because red lochia with small clots is expected during the early postpartum period. Choice B is incorrect as the fundus should be firm and midline, not at the umbilicus. Choice D is incorrect as perineal pain and swelling are common postpartum findings that do not require immediate reporting to the provider.

4. A nurse is caring for a client who has a wound infection and is receiving gentamicin. Which of the following laboratory values should the nurse monitor to detect an adverse effect of this medication?

• A. Creatinine.
• B. Aspartate aminotransferase (AST).
• C. White blood cell count.
• D. Serum glucose.

Correct answer: A

Rationale: The correct answer is A: Creatinine. Gentamicin can cause nephrotoxicity, leading to impaired kidney function. Monitoring creatinine levels helps the nurse detect any potential kidney damage. Choice B, Aspartate aminotransferase (AST), is not typically affected by gentamicin. Choice C, White blood cell count, is not directly related to gentamicin adverse effects. Choice D, Serum glucose, is not specifically monitored for gentamicin adverse effects.

5. How should a healthcare professional manage a patient with non-compliance to hypertension medication?

• A. Provide education on medication
• B. Refer the patient to a specialist
• C. Discontinue the medication
• D. Reassess the patient in 6 months

Correct answer: A

Rationale: Providing education on medication is crucial when managing a patient with non-compliance to hypertension medication. By educating the patient on the importance of adherence, potential side effects, and the impact of uncontrolled hypertension, healthcare professionals can help improve the patient's understanding and compliance. Referring the patient to a specialist (Choice B) may be necessary in some cases but should not be the first step. Discontinuing the medication (Choice C) without exploring reasons for non-compliance and providing education can worsen the patient's condition. Reassessing the patient in 6 months (Choice D) is important but should be accompanied by interventions to address non-compliance in the interim.

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