Nursing Elites

1. When assessing a client for an endocrine dysfunction, which question should the nurse ask?

• A. “Have you noticed any pain in your legs when walking?”
• B. “Have you had any unexplained weight loss?”
• C. “Have you noticed any change in your bowel movements?”
• D. “Have you experienced any joint pain or discomfort?”

Correct answer: B

Rationale: The correct answer is B: “Have you had any unexplained weight loss?” Unexplained weight loss can be a common symptom of various endocrine disorders, such as hyperthyroidism and diabetes. This weight loss is often despite an adequate or increased appetite. Choices A, C, and D are less likely to be directly associated with endocrine dysfunction. Pain in the legs when walking could be related to musculoskeletal issues, changes in bowel movements may suggest gastrointestinal concerns, and joint pain is more commonly linked to rheumatologic conditions rather than primary endocrine disorders.

2. Which of the following is a common side effect of the drug metformin?

• A. Weight loss
• B. Weight gain
• C. Drowsiness
• D. Hypertension

Correct answer: A

Rationale: The correct answer is A, weight loss. Metformin is commonly associated with weight loss as a side effect rather than weight gain. Metformin works by decreasing glucose production in the liver and improving insulin sensitivity, which can lead to weight loss. Choices B, C, and D are incorrect because weight gain, drowsiness, and hypertension are not typically common side effects of metformin.

3. The nurse has been assigned to train the unlicensed nursing assistant about prioritizing care. Which client should the nurse instruct the unlicensed nursing assistant to see first?

• A. The client who needs both sequential compression devices removed
• B. The elderly woman who needs assistance ambulating to the bathroom
• C. The surgical client who needs help changing the gown after bathing
• D. The male client who needs the intravenous fluid discontinued

Correct answer: A

Rationale: The correct answer is A. Removing sequential compression devices could increase the risk of thromboembolism, which is a serious complication. Therefore, this client should be seen first to prevent any potential harm. Choice B may be important, but it does not pose an immediate risk compared to thromboembolism. Choice C is a routine care task that can be delayed, and Choice D, discontinuing intravenous fluid, is important but not as urgent as preventing thromboembolism.

4. The nurse on the medical/surgical unit cares for a client with a diagnosis of cerebrovascular accident (CVA). The nursing assessment of the client’s neurological status should include which of the following? (Select all that apply)

• A. Obtain the pulses in all four extremities
• B. Ask the client to grasp and squeeze two fingers on each of the nurse’s hands
• C. Determine the client’s orientation to person, place, and time
• D. B, C

Correct answer: D

Rationale: The correct choices are B and C. Assessing grasp strength and orientation to person, place, and time are essential components of a neurological assessment after a CVA. Pulse assessment in all four extremities is more relevant to circulatory assessment rather than neurological status. Therefore, option A is incorrect.

5. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

• A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
• B. Motrin (ibuprofen), an NSAID, PRN
• C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
• D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

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