Nursing Elites

1. The nurse is monitoring a client who has just had a thyroidectomy. The client complains of tingling in the fingers and around the mouth. Which of these findings should the nurse assess first?

• A. Calcium level
• B. Chvostek's sign
• C. Trousseau's sign
• D. Serum potassium level

Correct answer: B

Rationale: The correct answer is B, Chvostek's sign. This is a classic sign of hypocalcemia, which can occur after a thyroidectomy due to injury or removal of the parathyroid glands. Hypocalcemia can lead to serious complications like tetany and laryngospasm, necessitating immediate attention. Assessing Chvostek's sign helps in early identification and management of hypocalcemia. Choices A, C, and D are not the priority in this situation. While assessing the calcium level is important for diagnosing hypocalcemia, the immediate concern is to identify clinical signs like Chvostek's sign, which indicate acute hypocalcemia. Trousseau's sign is also related to hypocalcemia but is not the most critical sign to assess first. Serum potassium level, although important for overall electrolyte balance, is not directly related to the client's current symptoms of tingling in the fingers and around the mouth.

2. A nurse is reinforcing teaching with a client about dietary choices for celiac disease. Which of the following menu choices selected by the client indicates an understanding of the teaching?

• A. Hamburger on a wheat bun
• B. Baked chicken and potato chips
• C. Bacon, lettuce, and tomato sandwich on rye toast
• D. Beef and barley soup with crackers

Correct answer: B

Rationale: The correct answer is B because baked chicken and potato chips are gluten-free options suitable for a client with celiac disease. Choice A, a hamburger on a wheat bun, contains gluten, which is harmful to individuals with celiac disease. Choice C, a bacon, lettuce, and tomato sandwich on rye toast, also contains gluten. Choice D, beef and barley soup with crackers, includes gluten from the barley and crackers, making it unsuitable for someone with celiac disease.

3. A healthcare provider is collecting data from a client who is receiving chemotherapy and is showing manifestations of malnutrition. Which of the following indicates a Vitamin C deficiency?

• A. Dry, red conjunctiva
• B. Swollen, bleeding gums
• C. Inflammation of the tongue
• D. Pale, brittle nails

Correct answer: B

Rationale: Swollen, bleeding gums are a classic sign of scurvy, which is caused by a deficiency in Vitamin C. Dry, red conjunctiva, inflammation of the tongue, and pale, brittle nails are not specific manifestations of Vitamin C deficiency, making them incorrect choices.

4. A client with pneumococcal pneumonia had been started on antibiotics 16 hours ago. During the nurse's initial evening rounds, the nurse notices a foul smell in the room. The client makes all of these statements during their conversation. Which statement would alert the nurse to a complication?

• A. I have a sharp pain in my chest when I take a breath.
• B. I have been coughing up foul-tasting, brown, thick sputum.
• C. I have been sweating all day.
• D. I feel hot off and on.

Correct answer: B

Rationale: Coughing up foul-tasting, brown, thick sputum suggests a possible abscess or secondary infection, requiring attention. Choice A may indicate pleurisy, but the focus should be on the sputum. Choice C may be non-specific and could be related to the infection or fever. Choice D is non-specific and may be expected during an infection.

5. A client who has received treatment for kidney stones should be reminded to increase intake of which of the following?

• A. Tea
• B. Sodium
• C. Water
• D. Protein

Correct answer: C

Rationale: The correct answer is C: Water. Increasing water intake helps prevent the formation of new kidney stones by diluting the urine. Tea (Choice A) contains oxalates, which can contribute to kidney stone formation. Sodium (Choice B) should be limited to prevent the risk of certain types of kidney stones. Protein (Choice D) intake should be moderate as excessive protein consumption may increase the risk of kidney stones. Therefore, advising the client to increase water intake is the most appropriate recommendation to prevent the recurrence of kidney stones.

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