Nursing Elites

1. A client who has a new prescription for levothyroxine is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

• A. ''I will need to take this medication for the rest of my life.''
• B. ''I will take this medication with an antacid.''
• C. ''I should avoid eating foods that contain iodine.''
• D. ''You should store this medication in the refrigerator.''

Correct answer: A

Rationale: The correct answer is A: ''I will need to take this medication for the rest of my life.'' Levothyroxine is a lifelong medication for clients with hypothyroidism and should be taken as prescribed. Choice B is incorrect because levothyroxine should not be taken with antacids as they can interfere with its absorption. Choice C is incorrect as iodine-containing foods do not need to be avoided with levothyroxine. Choice D is incorrect because levothyroxine should be stored at room temperature, not in the refrigerator.

2. A nurse is caring for a client who is postoperative following a hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the prosthesis?

• A. Place a pillow between the client's legs.
• B. Place the client in a high Fowler's position.
• C. Maintain the client in a side-lying position.
• D. Keep the client's legs elevated.

Correct answer: A

Rationale: Placing a pillow between the client's legs is the correct action to prevent dislocation of the prosthesis after hip arthroplasty. This positioning helps maintain proper alignment and stability of the hip joint, reducing the risk of dislocation. Placing the client in a high Fowler's position (choice B) is not recommended after hip arthroplasty as it may strain the hip joint. Maintaining the client in a side-lying position (choice C) or keeping the client's legs elevated (choice D) does not provide the same level of support and alignment as placing a pillow between the legs.

3. A nurse is assessing a client who is 1 hour postoperative following a hysterectomy. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 78/min.
• B. Blood pressure of 120/80 mm Hg.
• C. Oxygen saturation of 94%.
• D. Respiratory rate of 16/min.

Correct answer: A

Rationale: A heart rate of 78/min is within the normal range; however, postoperative patients require close monitoring for any signs of complications. While the heart rate is normal, other critical findings such as increased pain, excessive bleeding, or other concerning symptoms may need immediate attention. Choices B, C, and D all indicate normal postoperative vital signs and oxygen saturation levels, which do not raise immediate concerns requiring reporting to the provider.

4. A healthcare professional is assessing a client who is receiving opioid analgesics. Which of the following findings should the professional report to the provider?

• A. Oxygen saturation of 94%
• B. Blood pressure of 110/70 mm Hg
• C. Respiratory rate of 12/min
• D. Heart rate of 88/min

Correct answer: C

Rationale: A respiratory rate of 12/min may indicate respiratory depression, a potential side effect of opioid analgesics. Respiratory depression can be a serious complication that requires immediate intervention. Monitoring the respiratory rate is crucial in clients receiving opioids to prevent adverse events. Oxygen saturation, blood pressure, and heart rate are important parameters to assess, but a low respiratory rate is a more critical finding that warrants immediate reporting to the healthcare provider.

5. A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?

• A. Blood glucose of 110 mg/dL.
• B. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
• C. WBC count of 6,500/mm3.
• D. Temperature of 37.3°C (99.1°F).

Correct answer: B

Rationale: A weight loss of 0.5 kg (1.1 lb) in 24 hours may indicate dehydration or malnutrition, which are critical concerns for a client receiving total parenteral nutrition (TPN). Therefore, the nurse should report this finding to the provider. Elevated blood glucose levels (Choice A) can be managed by adjusting TPN components, WBC count (Choice C) and a slightly elevated temperature (Choice D) are not directly related to TPN administration and may not require immediate intervention.

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