Nursing Elites

1. Which of the following is an expected finding in a patient with hypothyroidism?

• A. Weight gain.
• B. Weight loss.
• C. Increased appetite.
• D. Diarrhea.

Correct answer: A

Rationale: Weight gain is an expected finding in hypothyroidism due to the decreased metabolic rate. Hypothyroidism leads to a slowing down of bodily functions, including metabolism, which can result in weight gain. Weight loss (Choice B) is more commonly associated with hyperthyroidism where there is an increase in metabolic rate. Increased appetite (Choice C) is also more typical of hyperthyroidism as the body is burning energy at a faster rate. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; instead, constipation is more often observed due to the slowing down of the digestive system.

2. A client with chronic kidney disease (CKD) is experiencing nausea, vomiting, visual changes, and anorexia. Which action by the nurse is best?

• A. Check the client’s digoxin (Lanoxin) level.
• B. Administer an anti-nausea medication.
• C. Ask if the client can eat crackers.
• D. Refer the client to a gastrointestinal specialist.

Correct answer: A

Rationale: In a client with chronic kidney disease experiencing symptoms like nausea, vomiting, visual changes, and anorexia, it is crucial for the nurse to suspect digoxin (Lanoxin) toxicity. These symptoms are indicative of digoxin toxicity. Therefore, the best action for the nurse to take is to check the client's digoxin level. Administering anti-nausea medication, asking about eating crackers, and referring to a gastrointestinal specialist may help with symptom management but do not address the underlying cause of the symptoms, which is digoxin toxicity in this case.

3. Which of the following conditions is the most significant risk factor for the development of type 2 diabetes mellitus?

• A. Cigarette smoking.
• B. High-cholesterol diet.
• C. Obesity.
• D. Hypertension.

Correct answer: C

Rationale: Obesity is the most significant risk factor for developing type 2 diabetes mellitus due to its role in insulin resistance. Excess body fat, especially around the abdomen, leads to increased production of inflammatory markers and hormones that can cause insulin resistance. While cigarette smoking, high-cholesterol diet, and hypertension can contribute to health issues, they are not as directly linked to the development of type 2 diabetes mellitus as obesity.

4. A client with renal calculi is being assessed by a nurse. Which question should the nurse ask?

• A. Is there a family history of this problem?
• B. Do you consume cranberry juice?
• C. Do you urinate after sexual intercourse?
• D. Do you have burning sensation during urination?

Correct answer: A

Rationale: When assessing a client with renal calculi, it is important for the nurse to inquire about a family history of the problem. There is a genetic predisposition associated with renal stone formation, making it essential to assess if other family members have experienced renal stones. Choices B, C, and D are not directly related to renal calculi. Consuming cranberry juice is more relevant to urinary tract health, urinating after sexual intercourse is related to preventing urinary tract infections, and experiencing a burning sensation during urination is a symptom commonly associated with urinary tract infections, not renal calculi.

5. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?

• A. Nausea and vomiting are uncommon adverse effects.
• B. The drug may cause possible teratogenic effects.
• C. Increase intake of dairy products with each dose of this medication.
• D. Use a backup method of contraception if taking oral contraceptives.

Correct answer: D

Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.

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