Nursing Elites

1. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse implement?

• A. Encourage increased fluid intake
• B. Administer vasopressin
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. SIADH leads to excessive release of antidiuretic hormone (ADH), causing the body to retain water and diluting the sodium levels in the blood (hyponatremia). Restricting oral fluids helps prevent further water retention and worsening hyponatremia. Encouraging increased fluid intake (choice A) would exacerbate the problem by further diluting sodium levels. Administering vasopressin (choice B) is not indicated in SIADH, as the condition is characterized by excess ADH secretion. Monitoring for signs of dehydration (choice C) is not the priority in SIADH since the issue is water retention rather than dehydration.

2. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

• A. Infusing I.V. fluids rapidly as ordered
• B. Encouraging increased oral intake
• C. Restricting fluids
• D. Administering glucose-containing I.V. fluids as ordered

Correct answer: C

Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.

3. During preoperative teaching for a female client undergoing subtotal thyroidectomy, which statement should the nurse include?

• A. The head of your bed must remain flat for 24 hours after surgery.
• B. You should avoid deep breathing and coughing after surgery.
• C. You won't be able to swallow for the first day or two.
• D. You must avoid hyperextending your neck after surgery.

Correct answer: D

Rationale: The correct answer is D. Instructing the client to avoid hyperextending the neck after thyroid surgery is crucial to prevent stress on the surgical site and reduce the risk of complications such as strain on the incision or damage to the healing tissues. Choices A, B, and C are incorrect because: A) Keeping the head of the bed flat for 24 hours is not necessary after a thyroidectomy; elevation of the head of the bed can actually help reduce swelling and improve comfort. B) Encouraging deep breathing and coughing after surgery is essential to prevent respiratory complications such as pneumonia, so this advice is incorrect. C) Difficulty swallowing after thyroid surgery is not a typical outcome, so this statement is inaccurate and should not be included in the preoperative teaching.

4. A client with hypothyroidism is prescribed levothyroxine. The nurse should teach the client to take this medication:

• A. With meals
• B. Before bedtime
• C. On an empty stomach in the morning
• D. With a glass of milk

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and efficacy. Taking it with meals (Choice A) may interfere with absorption due to food interactions. Taking it before bedtime (Choice B) can lead to difficulties with absorption and may disrupt the sleep cycle. Consuming levothyroxine with a glass of milk (Choice D) is not recommended as calcium in milk can interfere with its absorption. Therefore, the best practice is to take levothyroxine on an empty stomach in the morning to ensure optimal effectiveness.

5. Which of the following best describes the nurse's role in patient education?

• A. The nurse is responsible for providing patients with information they need to make informed decisions about their care.
• B. The nurse provides education to the patient and their family to help them understand the care plan and make informed decisions.
• C. The nurse is responsible for providing patients with written materials to help them understand their condition and treatment options.
• D. The nurse provides patients with verbal and written instructions on how to manage their care at home.

Correct answer: A

Rationale: The correct answer is A. The nurse's role in patient education involves providing patients with the necessary information to make informed decisions about their care. This includes explaining treatment options, potential risks and benefits, and answering any questions the patient may have. Choice B is incorrect because while nurses do educate patients and families, the primary focus is on empowering patients to make informed decisions. Choice C is incorrect as providing written materials is a part of patient education but not the sole responsibility of the nurse. Choice D is incorrect because while nurses do provide instructions on managing care at home, patient education goes beyond just the home care aspect to encompass a broader understanding of the patient's condition and treatment.

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