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 planning assignments for a licensed practical nurse (LPN) during a staffing shortage. Which client should be delegated to the LPN?

• A. A client with an Hgb of 6.3 g/dl and a prescription for packed RBCs.
• B. A client who sustained a concussion and has unequal pupils.
• C. A client who is postoperative following a bowel resection with an NG tube set to continuous suction.
• D. A client who fractured his femur yesterday and is experiencing shortness of breath.

Correct answer: C

Rationale: The correct answer is C because the client postoperative following a bowel resection with an NG tube set to continuous suction requires routine postoperative care, which an LPN can manage. Choice A involves administering blood products, which typically requires assessment and monitoring by a registered nurse. Choice B indicates a potentially serious neurological condition that requires assessment by a higher-level provider. Choice D suggests a client experiencing respiratory distress, which requires immediate assessment and intervention by a registered nurse or physician.

3. A nurse is reviewing the medical record of a client who is scheduled for surgery. Which of the following findings should the nurse report to the provider?

• A. Client reports taking warfarin
• B. Client has a history of hypertension
• C. Client ate a light breakfast 2 hours prior
• D. Client reports a history of smoking 10 cigarettes a day

Correct answer: A

Rationale: The correct answer is A. Warfarin is an anticoagulant that increases the risk of bleeding during surgery. It is crucial for the provider to be informed about the client taking warfarin to adjust the treatment plan accordingly. Choices B, C, and D are not as critical to report for surgical planning. A history of hypertension (B) is important but may not require immediate intervention for surgery. Eating a light breakfast 2 hours prior (C) is a normal preoperative instruction. Smoking history (D) is relevant for overall health assessment but is not as urgent as the use of warfarin before surgery.

4. A nurse is providing teaching about newborn care to a group of parents. Which of the following instructions should the nurse include?

• A. You should not bathe your newborn every day.
• B. You should avoid covering your newborn with a heavy blanket during naps.
• C. You should expect your newborn's stools to be soft and yellow.
• D. You should keep your newborn's head elevated while they sleep.

Correct answer: D

Rationale: The correct answer is D: 'You should keep your newborn's head elevated while they sleep.' Keeping the newborn's head elevated while sleeping helps prevent conditions like sudden infant death syndrome (SIDS). Choice A is incorrect because newborns do not need to be bathed every day; it is recommended to bathe them 2-3 times a week. Choice B is incorrect as heavy blankets can increase the risk of suffocation for newborns. Choice C is incorrect as newborn stools are typically soft and yellow in color, not firm and light brown.

5. A nurse is preparing to administer an intermittent enteral feeding to a client who has a gastrostomy tube. Which of the following actions should the nurse take?

• A. Flush the tube with 30 mL of water after feeding
• B. Flush the tube with 10 mL of sterile water before feeding
• C. Place the client in a left lateral position
• D. Place the feeding bag 61 cm (24 in) above the client's abdomen

Correct answer: B

Rationale: Administering an intermittent enteral feeding through a gastrostomy tube requires flushing the tube with 10 mL of sterile water before feeding. This action helps ensure patency and prevents clogging. Choice A is incorrect because flushing after feeding does not address the need for pre-feeding tube flushing. Choice C is unrelated to tube feeding administration. Choice D is incorrect as the height of the feeding bag above the abdomen is typically regulated by healthcare facility policies and is not a universal standard.

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