Nursing Elites

1. A community health nurse is reviewing information about infectious diseases with the nurses on her team. The nurse should remind the team that which of the following diseases is included in the list of nationally notifiable infectious diseases?

• A. Influenza
• B. Tuberculosis
• C. Gonorrhea
• D. Hepatitis B

Correct answer: C

Rationale: The correct answer is Gonorrhea. Gonorrhea is a reportable sexually transmitted disease, and healthcare providers must report cases to the CDC to track and prevent outbreaks. Influenza, Tuberculosis, and Hepatitis B are not nationally notifiable infectious diseases. Influenza is monitored for its epidemiology and impact on public health, but it is not classified as nationally notifiable. Tuberculosis and Hepatitis B are not included in the list of diseases that healthcare providers are required to report to public health authorities.

2. A nurse is caring for a client prescribed sildenafil for erectile dysfunction. Which of the following should the nurse monitor?

• A. Blood pressure
• B. Heart rate
• C. Temperature
• D. Respiratory rate

Correct answer: A

Rationale: The correct answer is A: Blood pressure. Sildenafil, a medication for erectile dysfunction, can cause changes in blood pressure. The nurse should monitor for hypotension as a potential side effect. Monitoring heart rate (choice B) is not a priority when administering sildenafil unless there are pre-existing heart conditions. Temperature (choice C) and respiratory rate (choice D) are typically not directly affected by sildenafil administration, making them less relevant for monitoring in this case.

3. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as a contraindication to ceftriaxone?

• A. Gentamicin
• B. Clindamycin
• C. Piperacillin
• D. Sulfamethoxazole-trimethoprim

Correct answer: C

Rationale: Ceftriaxone is a cephalosporin, and individuals with a penicillin allergy (such as Piperacillin) may have cross-sensitivity, making it contraindicated. Gentamicin (Choice A) belongs to the aminoglycoside class, not related to cephalosporins. Clindamycin (Choice B) is a lincosamide antibiotic and is not typically associated with cross-allergies to cephalosporins. Sulfamethoxazole-trimethoprim (Choice D) is a sulfonamide antibiotic, also not directly related to ceftriaxone.

4. A nurse is caring for a client with deep vein thrombosis (DVT). Which of the following interventions should the nurse include in the plan of care?

• A. Position the client with the affected leg below the heart
• B. Massage the affected extremity every 4 hours
• C. Apply cold compresses to the affected extremity
• D. Elevate the affected leg while in bed

Correct answer: D

Rationale: The correct answer is to elevate the affected leg while in bed. Elevating the leg helps reduce swelling and promotes venous return, aiding in the management of DVT. Positioning the affected leg below the heart can worsen the condition by increasing the risk of clot dislodgment. Massaging the affected extremity can also dislodge the clot and should be avoided. Cold compresses are not recommended as they can cause vasoconstriction, potentially worsening the condition.

5. An antepartum client is Rh negative and understands that she will receive a RhoGAM injection during her pregnancy. The client asks the nurse if she will also receive a RhoGAM injection after the birth of her baby. The client will receive RhoGAM after the birth if blood tests are:

• A. Mother Rh positive; baby Rh negative
• B. Mother Rh negative; Coombs positive; baby Rh negative
• C. Mother Rh positive; Coombs negative; baby Rh positive
• D. Mother Rh negative; Coombs negative; baby Rh positive

Correct answer: D

Rationale: The correct answer is D. If the baby is Rh positive and the mother is Rh negative, the mother may develop antibodies against the baby's blood. RhoGAM is administered to prevent the mother's immune system from becoming sensitized to Rh-positive blood. Therefore, the mother, who is Rh negative, will receive RhoGAM after birth if the baby is Rh positive and both the mother and baby have negative Coombs tests. Choices A, B, and C are incorrect because they do not match the criteria for RhoGAM administration in this scenario.

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