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1. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?
- A. Increase thyroid hormone production
- B. Suppress thyroid hormone production
- C. Enhance iodine absorption
- D. Stimulate the thyroid gland
Correct answer: B
Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.
2. An adolescent patient seeks care in the emergency department after sharing needles for heroin injection with a friend who has hepatitis B. To provide immediate protection from infection, what medication will the nurse administer?
- A. Corticosteroids
- B. Gamma globulin
- C. Hepatitis B vaccine
- D. Fresh frozen plasma
Correct answer: B
Rationale: In this scenario, the immediate need is to provide passive immunity to the adolescent patient. Gamma globulin contains antibodies against hepatitis B, which can offer immediate protection. The hepatitis B vaccine provides active immunity over time but is not immediate. Fresh frozen plasma and corticosteroids are not indicated for immediate protection against hepatitis B infection. Therefore, the correct choice is Gamma globulin as it can provide immediate passive immunity against hepatitis B.
3. A client with a history of chronic heart failure is experiencing severe shortness of breath and has pink, frothy sputum. Which action should the nurse take first?
- A. Administer morphine sulfate.
- B. Place the client in a high Fowler's position.
- C. Initiate continuous ECG monitoring.
- D. Prepare the client for intubation.
Correct answer: B
Rationale: In a client with chronic heart failure experiencing severe shortness of breath and pink, frothy sputum, the priority action for the nurse is to place the client in a high Fowler's position. This position helps improve lung expansion, ease breathing, and enhance oxygenation by reducing venous return and decreasing preload on the heart. It is crucial to address the client's respiratory distress promptly before considering other interventions. Administering morphine sulfate (choice A) may be appropriate later to relieve anxiety and reduce the work of breathing, but positioning is the priority. Continuous ECG monitoring (choice C) and preparing for intubation (choice D) are important but secondary to addressing the respiratory distress and optimizing oxygenation.
4. A client is admitted with suspected meningitis. Which assessment finding requires immediate intervention?
- A. Headache.
- B. Fever.
- C. Nuchal rigidity.
- D. Seizures.
Correct answer: D
Rationale: Seizures in a client with suspected meningitis indicate increased intracranial pressure or other complications requiring immediate intervention. Seizures can lead to further neurological damage and need prompt management to prevent adverse outcomes. Therefore, addressing seizures promptly is crucial in the care of a client with suspected meningitis.
5. A young adult female client is seen in the emergency department for a minor injury following a motor vehicle collision. She states she is very angry at the person who hit her car. What is the best nursing response?
- A. You are lucky to be alive. Be grateful no one was killed.'
- B. I understand your car was not seriously damaged.'
- C. You are upset that this incident has brought you here.'
- D. Have you ever been in the emergency department before?'
Correct answer: C
Rationale: Validating the client's feelings can help her express and manage her emotions effectively.
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