Nursing Elites

1. A community nurse is instructing a group of high school students about the transmission of hepatitis A. Which mode of transmission should the nurse include in the teaching?

• A. Sexual contact
• B. Airborne droplets
• C. Fecal-oral
• D. Bloodborne

Correct answer: C

Rationale: The correct answer is C: Fecal-oral. Hepatitis A is primarily transmitted through the fecal-oral route, often from consuming contaminated food or water. Choice A, sexual contact, is not a typical mode of transmission for hepatitis A. Choice B, airborne droplets, is more characteristic of diseases like influenza or tuberculosis. Choice D, bloodborne transmission, is more relevant to hepatitis B and C, not hepatitis A.

2. During a breast examination on a 24-year-old client, the nurse notes the following findings. Which finding is of most concern and should be reported to the provider?

• A. An irregularly shaped, nontender lump palpable in the right breast
• B. Tenderness present during menstruation
• C. Bilateral, symmetrical lumps that move with palpation
• D. The client reports breast tenderness before menstruation

Correct answer: A

Rationale: An irregularly shaped, nontender lump is a concerning finding as it may indicate breast cancer. The nurse should report this finding to the provider for further investigation. Choices B, C, and D are less concerning findings. Tenderness during menstruation is a common finding due to hormonal changes. Bilateral, symmetrical lumps that move with palpation are often benign findings like fibrocystic changes. Breast tenderness before menstruation is also a common occurrence related to hormonal fluctuations.

3. While caring for a client receiving patient-controlled analgesia (PCA), which of the following interventions should the nurse take?

• A. Encourage the client to use the PCA before dressing changes.
• B. Monitor the client's respiratory status.
• C. Provide oxygen therapy to the client as needed.
• D. Ensure the PCA pump is functioning properly.

Correct answer: A

Rationale: Corrected Rationale: The nurse should encourage the client to use the PCA pump before activities like dressing changes, which are likely to cause pain, to ensure effective pain management. Monitoring the client's respiratory status (Choice B) is important but not the priority in this scenario. Providing oxygen therapy (Choice C) is not a routine intervention for all clients on PCA unless specifically indicated. Ensuring the PCA pump is functioning properly (Choice D) is essential, but encouraging the client to use the PCA before painful activities takes precedence to manage pain effectively.

4. A healthcare provider is preparing to administer a vaccine to a child. Which of the following should the provider verify?

• A. Allergy to eggs
• B. Previous vaccination history
• C. Family medical history
• D. Growth charts

Correct answer: B

Rationale: The healthcare provider should verify the child's previous vaccination history to ensure they are up to date with immunizations. This is important to prevent unnecessary or duplicate vaccinations and ensure the child is adequately protected against vaccine-preventable diseases. Checking for allergies to eggs is relevant for certain vaccines like the influenza vaccine but is not the top priority in this scenario. Family medical history and growth charts are not directly related to the administration of vaccines and are not as crucial as confirming the child's vaccination status.

5. A client has been prescribed albuterol. Which of the following is a priority adverse effect the nurse should monitor?

• A. Tachycardia
• B. Bradycardia
• C. Dizziness
• D. Hypertension

Correct answer: A

Rationale: Corrected Rationale: Albuterol, a beta-2 adrenergic agonist, can lead to tachycardia due to its stimulant effect on beta-2 receptors in the heart. Monitoring for tachycardia is crucial as it can be a sign of excessive sympathetic stimulation and may lead to severe complications. Bradycardia, dizziness, and hypertension are less likely adverse effects of albuterol, making them lower priority for monitoring in this context.

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