Nursing Elites

1. The nurse is caring for a client with hyperthyroidism. Which intervention should the nurse implement to manage the client's condition?

• A. Provide a high-calorie diet.
• B. Encourage frequent rest periods.
• C. Restrict fluid intake.
• D. Administer a stool softener.

Correct answer: B

Rationale: Encouraging frequent rest periods is essential in managing hyperthyroidism as it helps address the fatigue and hypermetabolic state commonly associated with this condition. Rest is crucial to support the body's recovery and reduce the stress on the thyroid gland. While nutrition is important in managing hyperthyroidism, providing a high-calorie diet is not the priority intervention. Restricting fluid intake is not typically necessary unless there are specific indications such as heart failure. Administering a stool softener is not directly related to managing hyperthyroidism.

2. A client with a history of diabetes mellitus is admitted with a foot ulcer. The nurse should recognize that which intervention is most critical in promoting healing of the foot ulcer?

• A. Strict control of blood glucose levels.
• B. Regular dressing changes with sterile technique.
• C. Application of antibiotic ointment.
• D. Hydrotherapy treatment daily.

Correct answer: A

Rationale: In diabetic clients with foot ulcers, strict control of blood glucose levels is essential for promoting wound healing. High blood glucose levels can impair circulation and compromise the body's ability to fight infection, delaying the healing process. By maintaining optimal blood glucose levels, the client's overall health and wound healing potential are improved.

3. A patient with chronic heart failure is prescribed furosemide. What is the primary action of this medication?

• A. Increase cardiac output
• B. Reduce fluid retention
• C. Decrease heart rate
• D. Lower blood pressure

Correct answer: B

Rationale: Furosemide is a loop diuretic that acts by inhibiting sodium and chloride reabsorption in the loop of Henle, leading to increased diuresis. By reducing fluid retention, furosemide helps decrease the workload on the heart in patients with chronic heart failure. This medication does not directly increase cardiac output, decrease heart rate, or lower blood pressure as its primary action.

4. A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?

• A. Presence of small blood clots in the drainage
• B. 60 mL of milky or cloudy drainage
• C. Spots of drainage on the dressings surrounding the drain
• D. 120 mL of serosanguinous drainage

Correct answer: B

Rationale: Milky or cloudy drainage can indicate infection or lymphatic leakage, which requires immediate attention. This finding may suggest a serious complication post neck dissection, warranting prompt notification of the healthcare provider for further evaluation and intervention.

5. A 65-year-old woman presents with difficulty swallowing, weight loss, and a history of long-standing heartburn. She has been on proton-pump inhibitors for years, but her symptoms have worsened. What is the most likely diagnosis?

• A. Peptic stricture
• B. Esophageal cancer
• C. Achalasia
• D. Esophageal spasm

Correct answer: B

Rationale: The presentation of difficulty swallowing, weight loss, and worsening symptoms despite long-term use of proton-pump inhibitors raises suspicion for esophageal cancer, especially in a patient with a history of chronic heartburn. Esophageal cancer should be considered in this scenario due to the concerning symptoms and lack of improvement despite appropriate medical management.

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