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 has pyelonephritis and expresses embarrassment about discussing symptoms. How should the nurse respond?

• A. Assure the client that their symptoms will be kept confidential.
• B. Acknowledge the client's discomfort and avoid discussing elimination topics.
• C. Encourage the use of familiar language and assure the client they can take their time.
• D. Offer the client a nurse of the same gender to provide care.

Correct answer: C

Rationale: When a client expresses embarrassment or discomfort in discussing symptoms related to sensitive topics like elimination and the genitourinary area, the nurse should respond by encouraging the client to use words they are comfortable with. This helps the client feel more at ease and opens up communication. Offering a nurse of the same gender may not address the client's discomfort with discussing symptoms. Assuring confidentiality is important, but it should not be promised in a way that may not be fulfilled. Avoiding the topic of elimination entirely does not address the client's feelings or promote effective communication.

3. The nurse is caring for a patient who has had severe vomiting. The patient’s serum sodium level is 130 mEq/L. The nurse will expect the patient’s provider to order which treatment?

• A. Diuretic therapy
• B. Intravenous hypertonic 5% saline
• C. Intravenous normal saline 0.9%
• D. Oral sodium supplements

Correct answer: C

Rationale: In this scenario, the patient has hyponatremia with a serum sodium level of 130 mEq/L. For a serum sodium level between 125 and 135 mEq/L, the appropriate treatment is intravenous normal saline 0.9%. Normal saline helps to increase the sodium content in the vascular fluid. Diuretic therapy would exacerbate sodium and fluid depletion, which is not suitable for a patient already dehydrated from severe vomiting. Intravenous hypertonic 5% saline is typically reserved for severe hyponatremia with a serum sodium level below 120 mEq/L. Oral sodium supplements are not feasible in this case as the patient is vomiting and may not be able to tolerate oral intake easily.

4. An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom?

• A. Leukocytosis and febrile.
• B. Polycythemia and crackles.
• C. Pharyngitis and sputum production.
• D. Confusion and tachycardia.

Correct answer: D

Rationale: The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch.

5. A client recovering from a urologic procedure is being assessed by a nurse. Which assessment finding indicates an obstruction of urine flow?

• A. Severe pain
• B. Overflow incontinence
• C. Hypotension
• D. Blood-tinged urine

Correct answer: B

Rationale: The correct answer is 'B: Overflow incontinence.' The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow. This obstruction can lead to overflow incontinence, which is the involuntary loss of urine when the bladder is distended. Severe pain is not typically associated with an obstruction of urine flow. Hypotension is unrelated to this issue. Blood-tinged urine is not a direct indication of an obstruction of urine flow but may indicate other conditions like trauma or infection.

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