Nursing Elites

1. A nurse is providing teaching to a client who has a new prescription for levothyroxine. Which of the following statements should the nurse include?

• A. Take this medication with food to prevent gastrointestinal upset.
• B. Take this medication in the morning to prevent insomnia.
• C. You may experience weight gain while taking this medication.
• D. You should avoid eating foods that contain iodine.

Correct answer: B

Rationale: The correct answer is B. Instructing the client to take levothyroxine in the morning is important to prevent insomnia, a common side effect of this medication. Choice A is incorrect as levothyroxine should be taken on an empty stomach. Choice C is inaccurate because weight loss, not weight gain, is a potential side effect of levothyroxine. Choice D is not necessary as clients do not need to avoid foods containing iodine while taking levothyroxine.

2. A nurse is caring for a client who has a history of alcohol use disorder and is experiencing withdrawal. Which of the following actions should the nurse take?

• A. Administer naloxone
• B. Administer diazepam
• C. Encourage oral fluid intake
• D. Administer magnesium sulfate

Correct answer: B

Rationale: The correct action for the nurse to take when caring for a client with alcohol use disorder experiencing withdrawal is to administer diazepam. Diazepam is a benzodiazepine commonly used to manage withdrawal symptoms in these clients by reducing anxiety, tremors, and the risk of seizures. Administering naloxone (Choice A) is used for opioid overdose, not alcohol withdrawal. Encouraging oral fluid intake (Choice C) is generally beneficial but not a specific intervention for alcohol withdrawal. Administering magnesium sulfate (Choice D) is not indicated for alcohol withdrawal but may be used for other conditions like preeclampsia or eclampsia.

3. A healthcare professional is reviewing the laboratory results of a client who has chronic kidney disease. Which of the following findings should the healthcare professional report to the provider?

• A. Serum potassium 4.5 mEq/L
• B. Serum calcium 9.2 mg/dL
• C. Serum creatinine 2.5 mg/dL
• D. Serum albumin 3.5 g/dL

Correct answer: C

Rationale: Elevated serum creatinine levels indicate impaired kidney function. As kidney disease progresses, the kidneys are less able to filter waste products, leading to an increase in creatinine levels. Therefore, a high serum creatinine level of 2.5 mg/dL should be reported to the provider for further evaluation and management. Choices A, B, and D are within normal ranges and do not directly signify worsening kidney function in this context.

4. A client receiving intermittent enteral feedings is being cared for by a nurse. Which action should the nurse take to reduce the risk of aspiration?

• A. Administer the feeding over 60 minutes.
• B. Position the client in a supine position during feedings.
• C. Elevate the head of the bed to 45 degrees during feedings.
• D. Flush the feeding tube with 60 mL of water before each feeding.

Correct answer: C

Rationale: The correct action to reduce the risk of aspiration during enteral feedings is to elevate the head of the bed to 45 degrees. This position helps prevent the reflux of feeding into the lungs. Administering the feeding over 60 minutes (Choice A) does not directly reduce the risk of aspiration. Positioning the client in a supine position (Choice B) increases the risk of aspiration as it promotes reflux. Flushing the feeding tube with water (Choice D) is important for tube patency but does not directly reduce the risk of aspiration.

5. A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin. Which of the following findings indicates the medication is effective?

• A. The client's urine output decreases.
• B. The client's blood pressure increases.
• C. The client's heart rate increases.
• D. The client's urine specific gravity decreases.

Correct answer: A

Rationale: The correct answer is A: 'The client's urine output decreases.' Desmopressin is used to treat diabetes insipidus by reducing excessive urine output. Therefore, a decrease in urine output indicates that the medication is effectively controlling the symptoms. Choices B, C, and D are incorrect because desmopressin primarily affects urine output, not blood pressure, heart rate, or urine specific gravity.

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