Nursing Elites

1. A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?

• A. "You should discuss the inheritance risk with your physician."?
• B. "Sickle cell disease is genetically based and might be passed on to children."?
• C. "Sickle cell disease is genetically based and is not passed on to children."?
• D. "Sickle cell disease is caused by an infection and cannot be passed on to children."?

Correct answer: B

Rationale: A client with sickle cell disease has a genetic condition that can be passed on to their offspring. The most appropriate statement for the PN to provide is to acknowledge this fact and inform the client that sickle cell disease is genetically based and might be passed on to children. This empowers the client with accurate information. Choice A has been refined to emphasize discussing the inheritance risk, making it a better option than the vague original choice. Choices C and D provide incorrect information. Sickle cell disease is indeed genetically based and can be inherited.

2. Which of the following viruses is most likely to be acquired through casual contact with an infected individual?

• A. influenza virus
• B. herpes virus
• C. cytomegalovirus (CMV)
• D. human immunodeficiency virus (HIV)

Correct answer: A

Rationale: The correct answer is influenza virus. Influenza virus is most likely to be acquired through casual contact with an infected individual as it is transmitted through respiratory droplets. Herpes virus is primarily transmitted by direct contact, such as skin-to-skin contact, making it less likely to be acquired through casual contact. HIV is mainly transmitted through blood and body fluids like semen and vaginal fluids, not through casual contact. Cytomegalovirus (CMV) is an opportunistic infection commonly affecting immunocompromised individuals and is usually transmitted through close personal contact, not casual contact.

3. A nurse is returning phone calls in a pediatric clinic. Which of the following reports most requires the nurse's immediate attention and phone call?

• A. An 8-year-old boy has been vomiting, appears to have slower movements, and has a history of an atrioventricular shunt placement.
• B. A 10-year-old girl feels a dull pain in her abdomen after doing sit-ups in gym class.
• C. A 7-year-old boy has been having a low fever and headache for the past 3 days and has a history of an anterior knee wound.
• D. A 7-year-old girl who had a cast on her right ankle is complaining of itching.

Correct answer: A

Rationale: The correct answer is the 8-year-old boy with vomiting, slower movements, and a history of an atrioventricular shunt placement. This report requires immediate attention because the symptoms could indicate a blocked shunt, which is a serious medical condition needing urgent evaluation and intervention. Slower movements in the context of an atrioventricular shunt history could suggest increased intracranial pressure. The other choices involve less urgent issues: choice B describes post-exercise pain, choice C presents with a low-grade fever and headache that could be due to a mild infection, and choice D reports itching associated with a cast, which is a common issue and less critical compared to a potentially blocked shunt.

4. The nurse is assessing the newborn's respirations. Which of these findings would indicate a need for follow-up and further intervention?

• A. irregular respirations
• B. abdominal respirations
• C. shallow respirations
• D. 70 breaths per minute

Correct answer: D

Rationale: The ideal respiratory rate in a newborn is 30-60 breaths per minute. A respiratory rate of 70 breaths per minute indicates tachypnea and may require intervention. Therefore, a rate of 70 breaths per minute would necessitate follow-up and further intervention. Irregular, abdominal, and shallow respirations are common in newborns and may not necessarily indicate the need for immediate follow-up or intervention.

5. The client is admitted with a period of unobserved loss of consciousness and now has an EEG scheduled this morning. What should the nurse implement?

• A. Keep NPO and hold medication.
• B. Hold sedatives, but allow the client to have breakfast and give other medicines.
• C. Administer medications, but hold anticonvulsants.
• D. Give additional fluids and some caffeine prior to the test.

Correct answer: C

Rationale: Prior to an EEG, it is essential for the client to eat to prevent a drop in blood sugar levels. The nurse should hold sedatives but allow the client to have breakfast and administer other necessary medications. Holding sedatives is crucial to ensure accurate EEG results, while providing breakfast helps maintain stable blood sugar levels. Administering other medications, excluding sedatives, is important for the client's overall care. Choices A, C, and D are incorrect because keeping the client NPO and holding medications, administering medications but holding anticonvulsants, and giving additional fluids and caffeine are not appropriate actions before an EEG.

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