Nursing Elites

1. A nurse is caring for a client with a history of heroin use who is intoxicated. Which finding should the nurse expect?

• A. Constricted pupils
• B. Dilated pupils
• C. Increased reflexes
• D. Elevated blood pressure

Correct answer: A

Rationale: The correct answer is A: Constricted pupils. Constricted pupils are a classic sign of opioid intoxication, including heroin. Opioids like heroin cause the pupils to constrict due to their effect on the autonomic nervous system. Dilated pupils, increased reflexes, and elevated blood pressure are not typically associated with opioid intoxication but may be seen with other substances or conditions.

2. A charge nurse is teaching a new nurse how to clean surfaces contaminated with blood. Which agent should the charge nurse include in the teaching?

• A. Hydrogen peroxide
• B. Chlorhexidine
• C. Isopropyl alcohol
• D. Chlorine bleach

Correct answer: D

Rationale: Chlorine bleach is the most appropriate agent for disinfecting surfaces contaminated with blood. It is effective in killing a wide range of pathogens, including viruses. Hydrogen peroxide (Choice A) is not as effective as chlorine bleach for bloodborne pathogen disinfection. Chlorhexidine (Choice B) and isopropyl alcohol (Choice C) are more commonly used for skin antisepsis rather than surface disinfection, making them less suitable options in this scenario.

3. Which of the following characteristics would indicate true labor in a client?

• A. Contractions are irregular and painless
• B. Fetus moves to an anterior position
• C. Bloody show is not present
• D. Contractions are regular in frequency

Correct answer: D

Rationale: The correct answer is D. True labor is characterized by regular contractions that increase in intensity and frequency. These contractions lead to cervical dilation and effacement, signaling the onset of labor. Choice A is incorrect because true labor contractions are regular and painful, not irregular and painless. Choice B is irrelevant to determining true labor. Choice C is also unrelated as the presence or absence of a bloody show does not definitively indicate true labor.

4. A public health nurse is developing a list of interventions to address the 3 core functions of public health. What interventions should the nurse include as a part of the assurance function?

• A. Collect data on health trends in the community.
• B. Organize an immunization clinic for at-risk members of the community.
• C. Develop policies to address health disparities.
• D. Conduct research on communicable diseases in the area.

Correct answer: B

Rationale: The correct answer is B: 'Organize an immunization clinic for at-risk members of the community.' The assurance function of public health involves ensuring that essential public health services, like immunizations, are provided to meet public health goals. Choice A, collecting data on health trends, is more aligned with the assessment function of public health. Choice C, developing policies to address health disparities, pertains to the policy development function. Choice D, conducting research on communicable diseases, is related to the research function rather than the assurance function.

5. A client at 38 weeks gestation with a history of herpes simplex virus 2 is being admitted. Which of the following questions is most appropriate to ask the client?

• A. Have your membranes ruptured?
• B. Do you have any active lesions?
• C. Are you positive for beta strep?
• D. How far apart are your contractions?

Correct answer: B

Rationale: The most appropriate question to ask a client with a history of herpes simplex virus 2 at 38 weeks gestation is whether they have any active lesions. Active herpes lesions during labor can necessitate a cesarean delivery to prevent neonatal transmission. Asking about ruptured membranes (choice A), beta strep status (choice C), or contraction timing (choice D) is important but not the priority when managing a client with a history of herpes simplex virus 2 due to the high risk of neonatal transmission.

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