Nursing Elites

1. Which nursing action is a priority when caring for a client with heart failure?

• A. Encourage the client to drink fluids frequently
• B. Weigh the client daily to monitor fluid balance
• C. Increase fluid intake to prevent dehydration
• D. Limit the client's sodium intake

Correct answer: B

Rationale: Weighing the client daily is a priority action when caring for a client with heart failure because it helps monitor fluid balance. This monitoring is essential in managing heart failure as it allows healthcare providers to assess for signs of fluid retention or depletion, which are crucial in adjusting treatment plans. Encouraging the client to drink fluids frequently (Choice A) may worsen fluid overload in heart failure patients. Increasing fluid intake (Choice C) can exacerbate fluid retention. While limiting sodium intake (Choice D) is important in heart failure management, monitoring fluid balance through daily weighing takes precedence as a priority nursing action.

2. A nurse is caring for a client post-op with a chest tube. What should the nurse check for regularly?

• A. Ensure the chest tube is periodically clamped
• B. Check for air leaks in the tubing
• C. Keep the client in a prone position for chest drainage
• D. Administer diuretics to prevent fluid buildup

Correct answer: B

Rationale: The correct answer is to check for air leaks in the tubing. Air leaks can compromise the function of the chest tube, leading to inadequate drainage and potentially causing complications for the client. Clamping the chest tube periodically is incorrect as it could lead to a buildup of fluid or air in the pleural space. Keeping the client in a prone position is not necessary for chest drainage, as the positioning may vary depending on the specific situation. Administering diuretics may not be directly related to monitoring the chest tube for proper function and is not a routine intervention for chest tube management post-op.

3. How should a healthcare provider assess and manage a patient with hyperthyroidism?

• A. Administer beta-blockers and monitor for signs of thyroid storm
• B. Encourage a high-protein, low-iodine diet
• C. Monitor for signs of bradycardia
• D. Provide iodine supplements and check for arrhythmias

Correct answer: A

Rationale: Administering beta-blockers is the initial management for hyperthyroidism to control symptoms such as tachycardia and tremors. Monitoring for signs of thyroid storm is crucial as it is a life-threatening complication of hyperthyroidism. Encouraging a high-protein, low-iodine diet (choice B) is not the primary intervention for managing hyperthyroidism. Monitoring for signs of bradycardia (choice C) is not typically seen in hyperthyroidism, as it often presents with tachycardia. Providing iodine supplements and checking for arrhythmias (choice D) are contraindicated in hyperthyroidism as they can worsen the condition.

4. A community health nurse is helping to reinforce teaching about hepatitis A with a group of employees at a childcare facility. Which of the following characteristics should the nurse identify as an external factor that can impede learning for the participants?

• A. High workload
• B. Limited knowledge on the subject
• C. Poor lighting
• D. Limited space in the learning area

Correct answer: C

Rationale: The correct answer is C: 'Poor lighting.' External factors such as lighting can significantly impact the learning environment, making it difficult for participants to engage effectively. Poor lighting can strain the eyes, cause discomfort, and lead to decreased concentration. Choices A, B, and D are internal factors or issues that are not directly related to the learning environment. High workload, limited knowledge on the subject, and limited space in the learning area may affect learning differently but do not impede learning through external factors like poor lighting does.

5. A nurse is caring for a client who is postoperative following a thyroidectomy and reports tingling and numbness in the hands. The nurse should expect to administer which of the following medications?

• A. Sodium bicarbonate.
• B. Calcium gluconate.
• C. Potassium chloride.
• D. Magnesium sulfate.

Correct answer: B

Rationale: Tingling and numbness in the hands can indicate hypocalcemia, a common complication following a thyroidectomy. Hypocalcemia requires immediate intervention to prevent severe complications like tetany and seizures. Calcium gluconate is the drug of choice for rapidly raising serum calcium levels in hypocalcemic patients. Sodium bicarbonate is not indicated for treating hypocalcemia or related symptoms. Potassium chloride is used to correct potassium imbalances, not calcium. Magnesium sulfate is not the appropriate treatment for hypocalcemia; it is commonly used for conditions like preeclampsia or eclampsia.

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