Nursing Elites

1. While palpating the gallbladder of a mildly obese client, what finding does the nurse expect if the gallbladder is inflamed?

• A. Severe tenderness and guarding
• B. Slight discomfort upon palpation
• C. A sensation of fullness
• D. No symptoms unless the gallbladder is extremely inflamed

Correct answer: A

Rationale: Correct. If the gallbladder is inflamed, the nurse would expect to find severe tenderness and guarding, which are typical signs of acute cholecystitis. This indicates an inflammatory process in the gallbladder. Choices B, C, and D are incorrect because slight discomfort, a sensation of fullness, or no symptoms unless extremely inflamed are not typical findings associated with gallbladder inflammation.

2. What might be suggested to a client with fibrocystic breasts in an attempt to help relieve symptoms?

• A. Increase intake of high-calcium foods in your diet
• B. Wear a supportive bra during the day and at night
• C. Take over-the-counter pain relievers
• D. Perform regular breast massage

Correct answer: B

Rationale: The correct answer is B: 'Wear a supportive bra during the day and at night.' Wearing a supportive bra is essential for individuals with fibrocystic breasts as it helps relieve discomfort by providing necessary support to reduce strain on breast tissue. Option A is incorrect as high-calcium foods are not directly related to symptom relief in fibrocystic breasts. Option C is not the first-line recommendation and may not address the underlying issue. Option D, performing regular breast massage, is not typically recommended and may not provide significant relief for fibrocystic breast symptoms.

3. A client with hypothyroidism is prescribed levothyroxine. What should the nurse include in the teaching plan about this medication?

• A. Take the medication with a full meal
• B. Take the medication on an empty stomach
• C. Take the medication at bedtime
• D. Take the medication as needed for symptoms

Correct answer: B

Rationale: The correct answer is B: 'Take the medication on an empty stomach.' Levothyroxine should be taken on an empty stomach to enhance absorption and effectiveness. The medication is typically taken in the morning before breakfast. Choice A is incorrect because taking levothyroxine with a full meal can decrease its absorption. Choice C is incorrect because bedtime dosing may lead to insomnia. Choice D is incorrect because levothyroxine is a daily medication for hypothyroidism, not to be taken as needed for symptoms.

4. Which self-care measure is most important for the nurse to include in the plan of care of a client recently diagnosed with type 2 diabetes mellitus?

• A. Maintaining a low-sugar diet
• B. Foot care
• C. Blood glucose monitoring
• D. Daily exercise

Correct answer: C

Rationale: Blood glucose monitoring is crucial for managing diabetes effectively. By monitoring blood sugar levels, individuals can understand how their lifestyle choices, medications, and diet affect their glucose levels. This information helps in making necessary adjustments to control blood sugar levels and prevent complications. While maintaining a low-sugar diet, foot care, and daily exercise are all important aspects of managing diabetes, blood glucose monitoring takes precedence as it provides real-time data for informed decision-making.

5. A client tells the nurse, 'I have something very important to tell you if you promise not to tell.' The best response by the nurse is

• A. I must document and report any information.
• B. I can't make such a promise.
• C. That depends on what you tell me.
• D. I must report everything to the treatment team.

Correct answer: B

Rationale: The correct answer is B because the nurse cannot promise confidentiality in this context. It is essential to prioritize the safety and well-being of the client and others. Certain information, such as harm to oneself or others, must be reported to ensure appropriate interventions are taken. Choice A is incorrect because while documentation is important, confidentiality cannot be guaranteed in this situation. Choice C is incorrect as the nurse should not make promises that may conflict with their professional responsibilities. Choice D is incorrect as reporting everything to the treatment team without discretion may breach client confidentiality.

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