Nursing Elites

1. A client with multiple sclerosis is receiving baclofen (Lioresal). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Muscle spasms
• C. Drowsiness
• D. Tachycardia

Correct answer: C

Rationale: The correct answer is C: Drowsiness. Baclofen, a muscle relaxant commonly used to treat conditions like multiple sclerosis, can cause drowsiness as a side effect. Monitoring for drowsiness is important to ensure the client's safety and well-being. Choice A, Hypertension, is incorrect because baclofen is not known to cause hypertension. Choice B, Muscle spasms, is not a common side effect of baclofen but rather the symptom it is used to treat. Choice D, Tachycardia, is also incorrect as baclofen is not associated with causing an increase in heart rate.

2. In combating myths and misconceptions about family planning in the community, what should you do first as a health educator?

• A. Identify the influential leaders of the community
• B. Select an approach to be used in correcting myths and misconceptions
• C. Decide who will be involved in the conference
• D. Identify myths and misconceptions prevailing in the community and their sources

Correct answer: D

Rationale: The correct answer is to identify myths and misconceptions prevailing in the community and their sources. This is the initial step in addressing misconceptions effectively. By understanding the specific myths and where they originate from, a health educator can tailor their approach to correct these misconceptions. Choice A is incorrect because while influential leaders can play a role, identifying myths comes first. Choice B is incorrect as selecting an approach should come after understanding the myths. Choice C is incorrect as deciding who will be involved in a conference is not the primary step in combating myths and misconceptions.

3. During the beginning shift assessment of a client with asthma who is receiving oxygen via nasal cannula at 2 liters per minute, the nurse would be most concerned about which unreported finding?

• A. Pulse oximetry reading of 89%
• B. Crackles at the base of the lungs on auscultation
• C. Rapid shallow respirations with intermittent wheezes
• D. Excessive thirst with a dry cracked tongue

Correct answer: C

Rationale: Rapid, shallow respirations with intermittent wheezes are concerning as they indicate a potential worsening of the client's asthma. This finding suggests airway narrowing, which can lead to respiratory failure. Immediate intervention is required to address this respiratory distress. A pulse oximetry reading of 89% is low and indicates hypoxemia, but the respiratory pattern described in option C takes priority as it directly reflects the client's respiratory status. Crackles at the base of the lungs suggest fluid accumulation, which is important but not as immediately critical as the respiratory distress in asthma. Excessive thirst and a dry cracked tongue may indicate dehydration, which is relevant but not as urgent as the respiratory compromise presented in option C.

4. A client was re-admitted to the hospital following a recent skull fracture. Which finding requires the nurse's immediate attention?

• A. Lethargy
• B. Agitation
• C. Ataxia
• D. Hearing loss

Correct answer: A

Rationale: Lethargy is a critical finding that requires the nurse's immediate attention when a client with a recent skull fracture is readmitted to the hospital. It can indicate increased intracranial pressure or other serious complications such as hemorrhage or infection. Addressing lethargy promptly is crucial to prevent further deterioration. Agitation, ataxia, and hearing loss are important to assess but do not signify the same level of urgency as lethargy in this context.

5. A key component of primary prevention strategies is:

• A. aggressive interventions
• B. detection
• C. culture
• D. education

Correct answer: D

Rationale: The correct answer is 'D: education.' Education plays a vital role in primary prevention strategies by empowering individuals with knowledge and skills to prevent the onset of diseases. Through education, people can make informed decisions about their health, adopt healthy behaviors, and engage in preventive measures. Choice A, 'aggressive interventions,' is incorrect as primary prevention focuses on proactive measures to avoid the development of diseases rather than aggressive reactive interventions. Choice B, 'detection,' is more aligned with secondary prevention, which involves early identification of diseases. Choice C, 'culture,' while important in shaping health behaviors, is not a key component specifically in primary prevention strategies.

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