Nursing Elites

1. All of the following factors, when identified in the history of a family, are correlated with poverty except:

• A. high infant mortality rate
• B. frequent use of Emergency Departments
• C. consultation with folk healers
• D. low incidence of dental problems

Correct answer: D

Rationale: Factors correlated with poverty often include a high infant mortality rate, frequent use of Emergency Departments, and consultation with folk healers, as these indicate limited access to healthcare. Dental problems are prevalent in poverty due to a lack of preventive care and access to treatments. High infant mortality is a significant issue linked with poverty as it reflects poor healthcare access. Families in poverty might resort to Emergency Departments for healthcare due to financial barriers. Consulting folk healers is common in communities with limited access to formal healthcare. However, a low incidence of dental problems is less likely in impoverished families due to the lack of preventive services and the presence of other health issues.

2. When an elder client asks the nurse whether he will be capable of sexual activity in old age, the best response by the nurse is:

• A. "Elder adults are psychologically and physically capable of engaging in sexual activity regardless of age-related changes."?
• B. "If you haven't been sexually active throughout your life, you will not be able to participate in sexual activity in old age."?
• C. "When intercourse isn't possible, many of your sexual needs can be met through intimacy and touch."?
• D. "You might find it takes longer for you to achieve an erection, but you can maintain it for a longer time."?

Correct answer: A

Rationale: The best response for the nurse when an elder client asks about capability for sexual activity in old age is to provide reassurance and open communication. Choice A is the correct answer as it acknowledges that elder adults can engage in sexual activity both physically and psychologically despite age-related changes. This response encourages further discussion and addresses the client's concerns. Choices B, C, and D contain some truths but are not the most therapeutic responses. Choice B implies that past sexual activity is a prerequisite for sexual activity in old age, which is not entirely accurate as intimacy can be experienced in various ways. Choice C, while true about alternative ways to meet sexual needs, does not directly address the client's question about sexual activity. Choice D focuses on the physiological aspect of sexual function, which is important but not the most appropriate initial response to the client's query.

3. The teaching plan for gay or lesbian parents who want to disclose their homosexuality to their children should include all of the following instructions except:

• A. disclose the information before the child knows or suspects.
• B. be comfortable with your sexual preference first.
• C. have the discussion in a quiet place where interruptions are unlikely.
• D. explain how your relationship with the child changes because of the discussion

Correct answer: D

Rationale: The correct answer is to explain how your relationship with the child changes because of the discussion. Children of gay and lesbian parents should be reassured that their relationship with their parent will not change due to the disclosure. Choices A, B, and C are all important aspects of the disclosure process. It is crucial to disclose the information before the child knows or suspects, be comfortable with your sexual preference first, and have the discussion in a quiet place to ensure a safe and open environment for communication. Explaining how the relationship with the child changes might create unnecessary anxiety or confusion. Children may have different reactions based on their age, understanding, and environment. Therefore, it is essential to maintain a sense of stability and security in the parent-child relationship while addressing any questions or concerns that may arise.

4. The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?

• A. "I take my Lipitor with a glass of milk after my breakfast."?
• B. "I take my Lipitor and wait 30 minutes before taking my other medications."?
• C. "I take my Lipitor 30 minutes after I eat something."?
• D. "I take my Lipitor and my other morning medications with my grapefruit juice at breakfast."?

Correct answer: D

Rationale: The correct answer is, 'I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.' This statement indicates a need for reinforced teaching because grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to break down the drug, which leads to excessive amounts of the drug in the body. Choices A, B, and C show appropriate timing and administration of Lipitor, whereas choice D poses a potential risk due to the interaction between grapefruit juice and Lipitor.

5. A nurse is preparing to measure a client's calf circumference. The nurse performs this procedure by performing which action?

• A. Placing a tape measure around the widest point of the lower leg
• B. Measuring 2 inches above the knee and placing the tape measure around the client's leg at this point
• C. Measuring 2 inches above the ankle and placing the tape measure around the client's leg at this point
• D. Measuring 2 inches below the patella and placing the tape measure around the client's leg at this point

Correct answer: A

Rationale: To measure a client's calf circumference accurately, a nurse should place a non-stretchable tape measure around the widest point of the lower leg. It is crucial to ensure that the tape measure is positioned at the same number of centimeters down from a specific landmark, such as the patella, on both legs for consistency. Placing the tape measure 2 inches above the knee (Option B), 2 inches above the ankle (Option C), or 2 inches below the patella (Option D) would not provide an accurate measurement of the calf circumference. Therefore, these options are incorrect choices.

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