Nursing Elites

1. Which of the following is a characteristic symptom of hypothyroidism?

• A. Fatigue.
• B. Weight gain.
• C. Cold intolerance.
• D. Heat intolerance.

Correct answer: C

Rationale: The correct answer is 'Cold intolerance.' Hypothyroidism is associated with a decreased metabolic rate, leading to a decreased ability to regulate body temperature and a feeling of being cold. Fatigue (Choice A) and weight gain (Choice B) are also common symptoms of hypothyroidism due to the overall slowing down of bodily functions. Heat intolerance (Choice D) is more commonly associated with hyperthyroidism, where the body's metabolism is overactive, leading to increased heat production.

2. A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse?

• A. Discuss what the treatment regimen means to him.
• B. Refer the client to a mental health nurse practitioner.
• C. Reschedule the appointments to another date and time.
• D. Discuss the option of peritoneal dialysis.

Correct answer: A

Rationale: The best initial action for the nurse in this scenario is to have a discussion with the client about what the treatment regimen means to him. It is important to assess the client's anxiety, coping styles, and acceptance of the required treatment for CKD. The client may be in denial of the diagnosis or may have concerns that need to be addressed. While rescheduling hemodialysis appointments could be helpful, referring the client to a mental health nurse practitioner or discussing peritoneal dialysis are not the most appropriate first steps. Understanding the client's perspective and concerns is crucial before exploring other interventions.

3. The client is planning care for a client who is receiving hemodialysis. Which of the following interventions should be included in the plan of care?

• A. Administer anticoagulants to prevent clot formation.
• B. Monitor the client for signs of infection.
• C. Provide the client with a high-protein diet.
• D. Encourage the client to drink at least 2 liters of fluid daily.

Correct answer: B

Rationale: Monitoring for signs of infection is crucial in clients receiving hemodialysis because they are at an increased risk of infection due to the invasive nature of the procedure. Administering anticoagulants is not typically a part of the routine care for clients undergoing hemodialysis unless specifically prescribed. While a high-protein diet may be beneficial for some clients, it is not a specific intervention related to hemodialysis. Encouraging fluid intake must be individualized based on the client's fluid status and should not be a generalized recommendation for all clients receiving hemodialysis.

4. A client is placed on fluid restrictions because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the client’s fluid balance is stable at this time?

• A. Decreased calcium levels
• B. Increased phosphorus levels
• C. No adventitious sounds in the lungs
• D. Increased edema in the legs

Correct answer: C

Rationale: The absence of adventitious sounds upon auscultation of the lungs is a key indicator that the client's fluid balance is stable. Adventitious sounds, such as crackles or wheezes, are typically heard in conditions of fluid overload, indicating that the body is retaining excess fluid. Choices A and B, decreased calcium levels and increased phosphorus levels, are common laboratory findings associated with chronic kidney disease (CKD) and are not directly related to fluid balance. Increased edema in the legs is a sign of fluid imbalance, suggesting fluid retention in the tissues, which would not indicate stable fluid balance in a client with CKD on fluid restrictions.

5. A client in a physician’s office has just made an appointment for an exercise stress test. The client should be instructed to:

• A. Wear sweatpants and a heavy sweatshirt
• B. Eat a small meal just before the procedure
• C. Wear comfortable rubber-soled shoes such as sneakers
• D. Avoid consuming caffeine for 30 minutes before the procedure

Correct answer: C

Rationale: The client should wear comfortable rubber-soled shoes, such as sneakers, for the exercise stress test. This choice ensures safety and stability during the procedure. Wearing sweatpants and a heavy sweatshirt (Choice A) would not be appropriate as the client needs to wear light, loose, comfortable clothing. Eating a small meal just before the procedure (Choice B) could lead to discomfort during the test. Avoiding caffeine for 30 minutes before the procedure (Choice D) is not a specific instruction related to the attire or preparation for the test.

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