Nursing Elites

1. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

• A. a radiologist
• B. a gynecologist
• C. a physiatrist
• D. an oncologist

Correct answer: B

Rationale: A 65-year-old female experiencing postmenopausal bleeding should be encouraged to see a gynecologist. Gynecologists specialize in treating and managing diseases of the female reproductive organs, making them the most appropriate physician for this issue. Postmenopausal bleeding can indicate various gynecological conditions such as endometrial atrophy, endometrial hyperplasia, or endometrial cancer, highlighting the importance of consulting a gynecologist for proper diagnosis and management. Radiologists evaluate X-rays, physiatrists manage rehabilitation teams, and oncologists treat clients with cancer. Therefore, in this case, the symptoms point towards a gynecological problem, emphasizing the necessity of seeking care from a gynecologist.

2. While performing a physical assessment on a 6-month-old infant, the nurse observes head lag. Which of the following nursing actions should the nurse perform first?

• A. Ask the parents to allow the infant to lie on his stomach to promote muscle development.
• B. Notify the physician because a developmental or neurological evaluation is indicated.
• C. Document the findings as abnormal in the nurse's notes.
• D. Explain to the parents that their child is likely to have developmental delays.

Correct answer: B

Rationale: Head lag should be completely resolved by 4 months of age. Continuing head lag at 6 months of age indicates the need for further developmental or neurological evaluation. Laying the infant on his stomach promotes muscle development of the neck and shoulder muscles, but because of the age of this child, a referral should be the first action. The findings are abnormal for a 6-month-old infant. Significant head lag can be seen in infants with Down syndrome and hypoxia, as well as neurological and other metabolic disorders. While some of these disorders might include developmental delays, stating this to the parents without a proper evaluation can cause unnecessary distress. The priority is to identify the cause of the head lag through a medical evaluation before discussing potential outcomes with the parents.

3. A sexually active adolescent asks the school nurse about the use of latex condoms and the reduction of the risk of sexually transmitted infections (STIs). The nurse provides which information to the adolescent?

• A. Using a latex condom is a good method for reducing the risk of sexually transmitted infections (STIs).
• B. The only way to reduce the risk of transmission of STIs is abstinence.
• C. A spermicide needs to be used along with a condom to prevent transmission of STIs.
• D. Using a latex condom can reduce the risk of transmission of STIs.

Correct answer: D

Rationale: The correct answer is that using a condom during intercourse can reduce the risk of STI transmission. Abstinence is a way to prevent STIs, but not the only way. Using a spermicide along with a condom can help prevent pregnancy, not STIs. While condoms may fail to prevent pregnancy, they are effective in reducing the risk of STI transmission. Therefore, using a latex condom for pregnancy prevention is not directly related to preventing the transmission of STIs.

4. A pregnant client asks how she can prevent getting Group B Strep. What is the LPN's best response?

• A. You cannot prevent getting Group B Strep; you can only treat it.
• B. You should have your partner wear a condom every time you have intercourse.
• C. You should be extra vigilant about hand-washing, especially in the third trimester.
• D. The Group B Strep vaccine is the only proven way to prevent the disease.

Correct answer: A

Rationale: The best response for the LPN to provide to a pregnant client concerned about preventing Group B Strep is that it cannot be prevented, only treated. Group B Strep is a normal flora found in the vagina, rectum, and intestines of about 25% of women and is not a sexually transmitted disease. Testing for Group B Strep is done in each pregnancy, usually around 35-37 weeks. If a woman tests positive, antibiotics are administered during labor to reduce the risk of complications for both the mother and the baby. Choice A is the correct answer as Group B Strep cannot be prevented but only treated. Choice B is incorrect; condom use does not prevent Group B Strep. Choice C is not the best response as hand-washing is important for general hygiene but does not specifically prevent Group B Strep. Choice D is incorrect as there is no vaccine available to prevent Group B Strep.

5. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:

• A. assessment.
• B. crisis intervention.
• C. empathetic concern.
• D. unwarranted intrusion

Correct answer: B

Rationale: Crisis intervention is the correct choice. Counseling by a nurse specialist after a traumatic event like rape falls under the Crisis Intervention Model. This approach aims to provide immediate support to individuals facing a crisis to enhance coping mechanisms. In this scenario, the nurse specialist is offering specialized care tailored to rape victims, helping the client navigate through the emotional aftermath of the traumatic experience. Choices A, C, and D are incorrect: A is not the correct answer as the nurse specialist is providing emotional support rather than conducting an assessment; C, while important, does not fully capture the specialized intervention being provided; and D is inaccurate as the nurse specialist's intervention is warranted and essential for the victim's well-being.

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