Nursing Elites

1. After receiving change-of-shift report, which patient should the nurse assess first?

• A. A patient with pneumonia who has crackles in the right lung base
• B. A patient with possible lung cancer who has just returned after bronchoscopy
• C. A patient with hemoptysis and a 16-mm induration with tuberculin skin testing
• D. A patient with chronic obstructive pulmonary disease (COPD) and pulmonary function testing (PFT) that indicates low forced vital capacity

Correct answer: B

Rationale: The correct answer is the patient with possible lung cancer who has just returned after bronchoscopy. After bronchoscopy, the patient may have decreased cough and gag reflexes, necessitating immediate assessment for airway patency to prevent potential complications. The other patients do not exhibit urgent clinical manifestations or have undergone recent procedures that require immediate attention. Therefore, they can be assessed after ensuring the safety and stability of the patient who has just returned after bronchoscopy.

2. While performing CPR, a healthcare provider encounters a client with a large amount of thick chest hair when preparing to use an automated external defibrillator (AED). What is the next appropriate action for the healthcare provider?

• A. Apply the pads to the chest and provide a shock
• B. Wipe the client's chest down with a towel before applying the pads
• C. Shave the client's chest to remove the hair
• D. Do not use the AED

Correct answer: C

Rationale: When using an AED, it is crucial for the pads to have good contact with the skin to effectively deliver an electrical shock. While AED pads can adhere to a client's chest even with some hair, thick chest hair can hinder proper current conduction. In such cases, it is recommended to shave the area of the chest where the pads will be applied. Most AED kits include a razor for this purpose. The healthcare provider should act promptly to minimize delays in defibrillation. Option A is incorrect because it may lead to ineffective treatment due to poor pad adherence. Option B is not the best course of action as wiping the chest may not resolve the issue of poor pad contact. Option D is incorrect as not using the AED could jeopardize the client's chance of survival in a cardiac emergency.

3. What term is used to refer to generalized wasting of body tissues and malnutrition?

• A. Entropion
• B. Confabulation
• C. Induration
• D. Cachexia

Correct answer: D

Rationale: Cachexia is the correct term used to describe the generalized wasting of body tissues, ill health, and malnutrition associated with some chronic diseases. It involves a loss of fat tissue to protect the bones and joints. Clients with cachexia are at risk of pressure ulcers and other complications due to malnutrition and poor health. Entropion refers to an eyelid condition, confabulation is a memory disturbance, and induration is the abnormal hardening of a part of the body.

4. What term is used to describe the sexual response changes among middle-aged men?

• A. Menopause
• B. Climacteric
• C. Generativity
• D. Maturity

Correct answer: B

Rationale: The correct answer is 'Climacteric.' Climacteric specifically refers to the period in middle-aged men characterized by sexual response changes, such as delayed arousal. Menopause, choice A, is incorrect as it is specific to women and marks the cessation of menstrual periods. Generativity, choice C, is unrelated as it refers to the concern for guiding the next generation. Maturity, choice D, is too broad and generally refers to reaching the adult stage of development, not specifically addressing sexual response changes in middle-aged men.

5. During an assessment, a nurse asks a patient, "If you had fever and vomiting for 3 days, what would you do?"? Which aspect of the mental status examination is the nurse assessing?

• A. Behavior
• B. Cognition
• C. Affect and mood
• D. Perceptual disturbances

Correct answer: B

Rationale: The nurse is assessing cognition in this scenario. Cognition involves evaluating a patient's judgment and decision-making abilities. By asking the patient what they would do in a specific situation, the nurse aims to determine the patient's cognitive function. A correct response indicating intact cognition would involve a decision like 'Call my doctor.' If the patient suggests inappropriate actions like 'I would stop eating' or 'I would just wait and see what happened,' it would suggest impaired judgment. The other options, behavior, affect and mood, and perceptual disturbances, refer to different aspects of the mental status examination and are not directly assessed through this question.

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