Nursing Elites

1. After working with a very demanding client, an unlicensed assistive personnel (UAP) tells the nurse, 'I have had it with that client. I just can't do anything that pleases him. I'm not going in there again.' The nurse should respond by saying

• A. He has a lot of problems. You need to have patience with him.
• B. I will talk with him and try to figure out what to do.
• C. He is scared and taking it out on you. Let's talk to figure out what to do.
• D. Ignore him and get the rest of your work done. Someone else can take care of him for the rest of the day.

Correct answer: C

Rationale: The correct response is to acknowledge the UAP's feelings while exploring the client's behavior. By stating, 'He is scared and taking it out on you. Let's talk to figure out what to do,' the nurse shows empathy and readiness to address the situation collaboratively. This approach helps maintain a therapeutic environment for both the UAP and the client. Choices A and D are dismissive and do not address the underlying issue or provide support. Choice B, while showing willingness to intervene, lacks the understanding of the client's potential fear and does not address the UAP's feelings.

2. A client with congestive heart failure is prescribed digoxin. What symptom indicates digoxin toxicity?

• A. Monitor for muscle weakness and fatigue.
• B. Monitor for increased appetite and weight gain.
• C. Monitor for nausea and vomiting.
• D. Monitor for blurred vision or seeing yellow halos around objects.

Correct answer: D

Rationale: Corrected Rationale: Blurred vision or seeing yellow halos around objects are signs of digoxin toxicity, which can be life-threatening. These symptoms indicate an overdose of digoxin, requiring immediate medical attention. Muscle weakness and fatigue (Choice A) are not typically associated with digoxin toxicity. Increased appetite and weight gain (Choice B) are not indicative of digoxin toxicity either. Nausea and vomiting (Choice C) are common side effects of digoxin but are not specific signs of toxicity. Therefore, the correct answer is to monitor for blurred vision or seeing yellow halos around objects.

3. A client with cirrhosis is prescribed spironolactone to manage ascites. Which serum laboratory value is most important for the nurse to monitor?

• A. Sodium
• B. Calcium
• C. Magnesium
• D. Potassium

Correct answer: D

Rationale: The correct answer is D: Potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring potassium levels is crucial to prevent complications like cardiac arrhythmias. Choices A, B, and C are incorrect because sodium, calcium, and magnesium levels are not directly affected by spironolactone use for managing ascites in cirrhosis.

4. A client with heart failure is receiving furosemide. What assessment finding indicates the medication is effective?

• A. Increased urine output and weight loss.
• B. Increased heart rate and blood pressure.
• C. Decreased edema and improved peripheral pulses.
• D. Decreased shortness of breath and clear lung sounds.

Correct answer: C

Rationale: The correct answer is C: 'Decreased edema and improved peripheral pulses.' In a client with heart failure, furosemide is a diuretic that helps reduce fluid overload. Therefore, a decrease in edema (swelling due to fluid retention) and improved peripheral pulses (indicating better circulation) are signs that the medication is effective. Choices A, B, and D are incorrect. Increased urine output and weight loss (Choice A) may indicate the diuretic effect of furosemide but do not specifically reflect its effectiveness in heart failure. Increased heart rate and blood pressure (Choice B) are not desired effects of furosemide and may suggest adverse reactions. Decreased shortness of breath and clear lung sounds (Choice D) are related to improved respiratory status and may not directly reflect the effectiveness of furosemide in addressing fluid overload.

5. The nurse is assessing a client with a new diagnosis of hyperthyroidism. Which assessment finding should the nurse expect?

• A. Decreased heart rate
• B. Increased appetite
• C. Cold intolerance
• D. Weight gain

Correct answer: B

Rationale: In hyperthyroidism, there is an increase in metabolism, leading to symptoms such as increased appetite, weight loss, and heat intolerance. Therefore, the nurse should expect an increased appetite in a client with hyperthyroidism. Choices A, C, and D are incorrect because decreased heart rate and cold intolerance are more commonly associated with hypothyroidism, while weight gain is not typically seen in hyperthyroidism.

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