Nursing Elites

1. A client has just been diagnosed with active tuberculosis. Which of the following nursing interventions should the nurse perform to prevent transmission to others?

• A. Begin drug therapy within 72 hours of diagnosis
• B. Place the client in a positive-pressure room
• C. Initiate standard precautions
• D. Place the client in a negative-pressure room

Correct answer: D

Rationale: A client diagnosed with active tuberculosis should be placed in isolation in a negative-pressure room to prevent transmission of infection to others. Placing the client in a negative-pressure room ensures that air is exhausted to the outside and received from surrounding areas, preventing tuberculin particles from traveling through the ventilation system and infecting others. Initiating standard precautions, as mentioned in choice C, is essential for infection control but is not specific to preventing transmission in the case of tuberculosis. Beginning drug therapy within 72 hours of diagnosis, as in choice A, is crucial for the treatment of tuberculosis but does not directly address preventing transmission. Placing the client in a positive-pressure room, as in choice B, is incorrect as positive-pressure rooms are used for clients with compromised immune systems to prevent outside pathogens from entering the room, which is not suitable for a client with active tuberculosis.

2. Which playroom activities should the nurse organize for a small group of 7-year-old hospitalized children?

• A. Sports and games with rules
• B. Finger paints and water play
• C. Dress-up clothes and props
• D. Chess and television programs

Correct answer: A

Rationale: The correct answer is 'Sports and games with rules.' For 7-year-old children, organized activities that involve rules are beneficial as they promote cooperation, logical reasoning, and the development of social skills. Sports and games with rules help children understand the importance of following guidelines, playing fairly, and working together towards a common goal. Finger paints and water play (choice B) may be more suitable for younger children and may not fully engage 7-year-olds in the same way that structured games would. Dress-up clothes and props (choice C) primarily encourage imaginative play but may not emphasize the same level of cooperation and rule-following as sports and games. Chess and television programs (choice D) may not be as interactive or physically engaging as sports and games, limiting the opportunities for social interaction and cooperation among the children.

3. A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:

• A. Should be taken in the morning
• B. May increase the client's energy level
• C. Does not need to be stored in a dark container
• D. May increase the client's heart rate

Correct answer: A

Rationale: The correct answer is that levothyroxine (Synthroid) should be taken in the morning. Taking it in the morning can help prevent interference with the client's sleeping pattern, as one of the side effects of levothyroxine is insomnia. Choice B is incorrect because levothyroxine is actually used to treat hypothyroidism and can help increase energy levels. Choice C is incorrect as there is no specific requirement for levothyroxine to be stored in a dark container. Choice D is incorrect because levothyroxine is more likely to increase heart rate rather than decrease it.

4. The nurse is caring for a 27-year-old female client with a venous stasis ulcer. Which nursing intervention would be most effective in promoting healing?

• A. Apply dressing using sterile technique
• B. Improve the client's nutrition status
• C. Initiate limb compression therapy
• D. Begin proteolytic debridement

Correct answer: B

Rationale: Venous stasis occurs when venous blood collects and stagnates in the lower leg due to incompetent venous valves. This leads to inadequate oxygen and nutrient supply to the cells in the lower extremities, resulting in cell death or necrosis. Venous stasis ulcers, characterized by shallow brown wounds with irregular margins, typically develop on the lower leg or ankle. The primary goal in managing clients with venous stasis ulcers is to promote healing. Proper nutrition plays a crucial role in wound healing. Nutritional deficiencies are common causes of venous ulcers, and a diet rich in protein, iron, zinc, and vitamins C and A is recommended to enhance wound healing. Applying dressings with sterile technique, initiating limb compression therapy, and beginning proteolytic debridement are important interventions in wound care but may not directly address the underlying issue of poor nutrition that is essential for healing venous stasis ulcers.

5. The nurse is caring for a 13-year-old following spinal fusion for scoliosis. Which of the following interventions is appropriate in the immediate post-operative period?

• A. Raise the head of the bed at least 30 degrees
• B. Encourage ambulation within 24 hours
• C. Maintain in a flat position, logrolling as needed
• D. Encourage leg contraction and relaxation after 48 hours

Correct answer: C

Rationale: In the immediate post-operative period following spinal fusion for scoliosis in a 13-year-old, it is important to maintain the patient in a flat position and perform logrolling as needed. This helps prevent injury to the surgical site and ensures proper spinal alignment. Raising the head of the bed at least 30 degrees is contraindicated as it can put strain on the surgical site. Encouraging ambulation within 24 hours may be appropriate in the recovery process but not in the immediate post-operative period. Encouraging leg contraction and relaxation after 48 hours may also be part of the rehabilitation process but is not a priority in the immediate post-operative period.

Similar Questions