Nursing Elites

1. A client with chronic kidney disease is experiencing pruritus. Which intervention should the nurse include in the plan of care?

• A. Administer antihistamines as prescribed.
• B. Apply moisturizing lotion to the skin.
• C. Use cool water for bathing.
• D. Encourage a high-protein diet.

Correct answer: A

Rationale: Correct. Administering antihistamines as prescribed is the appropriate intervention for a client with chronic kidney disease experiencing pruritus. Antihistamines can help reduce pruritus by blocking histamine receptors, which are often prescribed for such clients. Choice B, applying moisturizing lotion, may help with dry skin but will not directly address pruritus. Choice C, using cool water for bathing, may provide some relief but does not target the underlying cause of pruritus. Choice D, encouraging a high-protein diet, is not directly related to managing pruritus in chronic kidney disease.

2. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding transmission of anthrax should the nurse provide to the group?

• A. Infection is acquired when anthrax spores enter a host.
• B. Mature anthrax bacteria live dormant on inanimate objects.
• C. Spores cannot survive for extended periods outside a living host.
• D. Anthrax is transmitted by respiratory droplets from person to person.

Correct answer: A

Rationale: The correct answer is A: Infection is acquired when anthrax spores enter a host. Anthrax is primarily transmitted through spores entering the body, either through the skin, inhalation, or ingestion. Person-to-person transmission of anthrax is extremely rare and not a significant mode of transmission. Choices B and C are incorrect because mature anthrax bacteria do not live dormant on inanimate objects, and spores can survive for extended periods outside a living host. Choice D is incorrect as anthrax is not transmitted by respiratory droplets from person to person.

3. The healthcare professional is developing a program to educate parents on the importance of immunizations. Which topic should be prioritized?

• A. the benefits of immunizations
• B. the potential side effects of vaccines
• C. the immunization schedule
• D. ways to comfort children during vaccinations

Correct answer: A

Rationale: Prioritizing the benefits of immunizations is crucial in helping parents comprehend the significance of vaccines in safeguarding their children against preventable diseases. Understanding the positive impact of immunizations can alleviate concerns and misconceptions that parents may have, ultimately encouraging them to make informed decisions regarding their children's health. Discussing potential side effects (choice B) is important but should come after highlighting the benefits to avoid instilling unnecessary fear. While the immunization schedule (choice C) is essential information, it may be overwhelming if presented as the initial focus. Comforting children during vaccinations (choice D) is valuable but secondary to ensuring parents understand the benefits of immunizations.

4. A female client is admitted with a tentative diagnosis of Guillain-Barre syndrome. Which finding is most important for the nurse to report to the healthcare provider?

• A. Facial weakness and difficulty speaking.
• B. Decreased deep tendon reflexes in the legs.
• C. Inability to move the eyes.
• D. Respiratory distress and cyanosis.

Correct answer: B

Rationale: In Guillain-Barre syndrome, decreased deep tendon reflexes are a critical finding that may indicate impending respiratory failure. This is due to the involvement of the peripheral nervous system affecting the muscles, including those involved in breathing. Reporting decreased deep tendon reflexes promptly is essential to prevent respiratory compromise. Facial weakness, difficulty speaking, and inability to move the eyes are common manifestations of Guillain-Barre syndrome but are not as immediately concerning as respiratory distress and impending respiratory failure.

5. A client with a history of hypertension is admitted with acute renal failure. Which assessment finding requires immediate intervention?

• A. Blood pressure of 180/100 mm Hg.
• B. Urine output of 50 mL in 4 hours.
• C. Heart rate of 100 beats per minute.
• D. Nausea and vomiting.

Correct answer: B

Rationale: Urine output of 50 mL in 4 hours indicates oliguria, which can be a sign of worsening renal function and requires immediate intervention. In acute renal failure, maintaining adequate urine output is crucial to prevent further kidney damage and manage fluid balance. A high blood pressure reading (Option A) is concerning but may not require immediate intervention in this scenario as it could be due to the history of hypertension. A heart rate of 100 beats per minute (Option C) is slightly elevated but may not be the most critical finding at this moment. Nausea and vomiting (Option D) are important to assess but are not as urgent as addressing oliguria in a client with acute renal failure.

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