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 with a recent diagnosis of myasthenia gravis. Which of the following medications should the nurse expect to administer?

• A. Methotrexate
• B. Pyridostigmine
• C. Baclofen
• D. Atropine

Correct answer: B

Rationale: Pyridostigmine is the drug of choice for treating myasthenia gravis because it enhances communication between nerves and muscles by inhibiting acetylcholinesterase. Methotrexate (choice A) is not indicated for myasthenia gravis but is used in conditions like rheumatoid arthritis. Baclofen (choice C) is a muscle relaxant used for conditions like spasticity. Atropine (choice D) is not typically used in myasthenia gravis as it can worsen muscle weakness.

3. A client who has been prescribed oral contraception receives education from a nurse. Which of the following client statements indicates a need for further education?

• A. If I miss one pill, I'll take it as soon as possible
• B. If I miss two pills, I'll double up for two days
• C. If I miss three pills, I'll double up each day until back on schedule
• D. I'll use an alternative form of contraception if I miss more than two pills

Correct answer: C

Rationale: The correct course of action after missing oral contraceptive pills depends on how many pills are missed. If three pills are missed, the client should not 'double up' but rather follow the manufacturer's instructions and use an alternative form of contraception until the next cycle. Taking too many pills at once increases the risk of side effects without restoring contraceptive protection. Choices A, B, and D demonstrate understanding of the correct actions to take after missing a pill or two, emphasizing the importance of not doubling up but following specific guidelines to maintain effectiveness and safety.

4. A nurse is providing discharge teaching to a client who has a prescription for home oxygen. Which information should the nurse teach?

• A. Use a humidifier with the oxygen
• B. Wear cotton socks when the oxygen is in use
• C. Avoid all types of smoking materials
• D. Use a nasal cannula during meals

Correct answer: B

Rationale: The correct answer is B: 'Wear cotton socks when the oxygen is in use.' This information is important as wearing cotton socks helps prevent static electricity, which can pose a fire risk when oxygen is in use. Choice A is incorrect as using a humidifier with oxygen is not necessary for all clients and may not be part of standard discharge teaching. Choice C is incorrect as it is a common safety measure to avoid all types of smoking materials when using oxygen. Choice D is incorrect as using a nasal cannula during meals is not specifically related to the safety concerns associated with home oxygen use.

5. A nurse is reviewing laboratory results for a client receiving chemotherapy. Which result should the nurse report to the provider?

• A. WBC 3,000/mm³
• B. Hemoglobin 12 g/dL
• C. Platelet count 250,000/mm³
• D. Serum sodium 140 mEq/L

Correct answer: A

Rationale: The correct answer is A: WBC 3,000/mm³. A WBC count of 3,000/mm³ indicates neutropenia, which is a condition characterized by a low level of white blood cells, specifically neutrophils. Neutropenia increases the risk of infection and requires immediate medical attention, especially in clients undergoing chemotherapy. Reporting this result to the provider promptly is crucial for further evaluation and intervention. Choices B, C, and D are within normal ranges and do not pose an immediate risk to the client's health. Hemoglobin of 12 g/dL, platelet count of 250,000/mm³, and serum sodium of 140 mEq/L are all normal values and would not typically require immediate reporting unless there are specific concerns related to the individual client's condition.

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