Nursing Elites

1. Which of the following is a key symptom of hyperthyroidism?

• A. Weight loss.
• B. Weight gain.
• C. Tachycardia.
• D. Dry skin.

Correct answer: A

Rationale: The correct answer is weight loss. In hyperthyroidism, there is an excess production of thyroid hormones leading to an increased metabolic rate. This increased metabolism can result in weight loss despite normal or increased appetite. Choice B (Weight gain) is more commonly associated with hypothyroidism where the metabolic rate is decreased. Choice C (Tachycardia) is another common symptom of hyperthyroidism due to the effects of thyroid hormones on the heart, causing an increased heart rate. Choice D (Dry skin) is not a typical symptom of hyperthyroidism; instead, it is more commonly associated with hypothyroidism.

2. A client with bladder cancer who underwent a complete cystectomy with ileal conduit is being assessed by a nurse. Which assessment finding should prompt the nurse to urgently contact the healthcare provider?

• A. The ileostomy is draining blood-tinged urine.
• B. There is serous sanguineous drainage on the surgical dressing.
• C. The ileostomy stoma appears pale and cyanotic.
• D. Oxygen saturations are 92% on room air.

Correct answer: C

Rationale: A pale or cyanotic appearance of the ileostomy stoma indicates compromised circulation, which can lead to necrosis if not promptly addressed. On the other hand, blood-tinged urine and serous sanguineous drainage are common following a complete cystectomy with ileal conduit. These findings do not typically indicate an urgent issue. An oxygen saturation of 92% on room air is slightly below the normal range but does not warrant urgent healthcare provider contact unless accompanied by significant respiratory distress or other concerning symptoms.

3. A client is vomiting. For which acid-base imbalance does the nurse assess the client?

• A. Metabolic acidosis
• B. Metabolic alkalosis
• C. Respiratory acidosis
• D. Respiratory alkalosis

Correct answer: B

Rationale: In a client who is vomiting, the loss of gastric fluid containing hydrochloric acid can lead to metabolic alkalosis. Metabolic alkalosis is caused by the loss of acids such as hydrochloric acid from the body. Therefore, in this scenario, the nurse should assess the client for metabolic alkalosis. Choices A, C, and D are incorrect because vomiting does not typically lead to metabolic acidosis, respiratory acidosis, or respiratory alkalosis.

4. When assessing an individual with peripheral vascular disease, which clinical manifestation would indicate complete arterial obstruction in the lower left leg?

• A. Aching pain in the left calf.
• B. Burning pain in the left calf.
• C. Numbness and tingling in the left leg.
• D. Coldness of the left foot and ankle.

Correct answer: D

Rationale: Coldness of the left foot and ankle is the correct clinical manifestation indicating complete arterial obstruction in the lower left leg. Complete arterial obstruction results in reduced blood flow, leading to decreased temperature in the affected area. Aching pain (Choice A) and burning pain (Choice B) are more commonly associated with partial obstructions or ischemia, while numbness and tingling (Choice C) can be indicative of nerve involvement or compromised circulation, but not specifically complete arterial obstruction. The coldness in the foot and ankle is a result of severely reduced blood flow, which impairs the delivery of oxygen and nutrients to the tissues in that area, leading to a lower temperature. This symptom is a critical indicator of a more severe blockage compared to the other options provided.

5. What do crackles heard on lung auscultation indicate?

• A. Cyanosis.
• B. Bronchospasm.
• C. Airway narrowing.
• D. Fluid-filled alveoli.

Correct answer: D

Rationale: Crackles heard on lung auscultation are caused by the popping open of small airways that are filled with fluid. This is commonly associated with conditions such as pulmonary edema, pneumonia, or heart failure. Cyanosis (Choice A) is a bluish discoloration of the skin and mucous membranes due to low oxygen levels in the blood, not directly related to crackles. Bronchospasm (Choice B) refers to the constriction of the airway smooth muscle, causing difficulty in breathing but does not typically produce crackles. Airway narrowing (Choice C) can lead to wheezing but is not directly linked to crackles heard on auscultation.

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