Nursing Elites

1. A client is admitted with a diagnosis of myocardial infarction (MI). The client is complaining of chest pain. The nurse knows that pain related to an MI is due to

• A. Insufficient oxygenation of the cardiac muscle
• B. Potential circulatory overload
• C. Left ventricular overload
• D. Electrolyte imbalance

Correct answer: A

Rationale: The correct answer is A: Insufficient oxygenation of the cardiac muscle. Myocardial infarction pain is primarily caused by inadequate oxygen reaching the heart muscle, leading to ischemia and tissue damage. Choices B, C, and D are incorrect because circulatory overload, left ventricular overload, and electrolyte imbalance are not the primary causes of chest pain in myocardial infarction. Circulatory overload may lead to other symptoms like edema, left ventricular overload can result in heart failure symptoms, and electrolyte imbalance may present with various manifestations, but none of these directly cause the characteristic chest pain associated with an MI.

2. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

3. The nurse is administering the measles, mumps, rubella (MMR) vaccine to a 12-month-old child during the well-baby visit. Which age range should the nurse advise the parents to plan for their child to receive the MMR booster based on the current recommendations and guidelines by the CDC?

• A. 13-18 years of age
• B. 11-12 years of age
• C. 18-24 months of age
• D. 4-6 years of age

Correct answer: D

Rationale: The correct answer is D: 4-6 years of age. The CDC recommends administering the MMR booster to children aged 4 to 6 years. This booster dose is essential to ensure continued immunity against measles, mumps, and rubella. Choices A, B, and C are incorrect because they do not align with the CDC guidelines for the age range of MMR booster administration.

4. Occupational health nursing is concerned with the following except:

• A. educating workers about health
• B. immediate diagnosis of illness prevailing in the work field
• C. appropriate and effective ways of promoting health
• D. planning of administering health services

Correct answer: B

Rationale: Occupational health nursing focuses on educating workers about health, promoting health through appropriate and effective ways, and planning and administering health services in the workplace. Immediate diagnosis of illness prevailing in the work field is typically not the primary role of occupational health nursing, as it usually involves prevention, education, and health promotion rather than diagnosing acute conditions.

5. The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?

• A. Weight reduction
• B. Stress management
• C. Physical exercise
• D. Smoking cessation

Correct answer: D

Rationale: The correct answer is D, smoking cessation. Smoking is a major and modifiable risk factor for cardiovascular disease. It is often the highest priority in cardiac risk reduction because stopping smoking has immediate and long-term benefits for heart health. Choices A, B, and C are also important in reducing cardiac risk factors, but smoking cessation takes precedence due to its significant impact on cardiovascular health.

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