Nursing Elites

1. A patient taking an oral contraceptive missed one pill. What should the nurse teach the patient to do?

• A. Take two pills as soon as you remember, then continue the regular schedule.
• B. Take one pill as soon as you remember, then continue the regular schedule.
• C. Skip the missed pill and continue the regular schedule.
• D. Take two pills immediately, then continue the regular schedule.

Correct answer: A

Rationale: When a patient taking an oral contraceptive misses one pill, the correct action is to take two pills as soon as they remember and then continue the regular schedule. Option A is the correct answer because doubling up the dose helps maintain the effectiveness of the contraceptive. Option B is incorrect because taking only one pill after missing one may decrease contraceptive effectiveness. Option C is wrong as skipping the missed pill can also reduce effectiveness. Option D is inaccurate because taking two pills immediately is not necessary; the patient should take the missed pill as soon as remembered and then resume the regular dosing schedule.

2. Joseph, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse. Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse’s priority intervention?

• A. Contact the child’s parents and ask about the child’s injuries.
• B. Encourage the child to be honest about the injuries.
• C. Question the teacher about the child's injuries.
• D. Report suspicion of abuse to the proper authorities.

Correct answer: D

Rationale: The school nurse's priority intervention in this situation is to report suspicion of abuse to the proper authorities. Given the pattern of unexplained injuries and vague explanations provided by the child, it raises significant concerns for possible abuse. Reporting to the appropriate authorities is crucial to ensure the child's safety and well-being. Contacting the child's parents (Choice A) may not be appropriate if abuse is suspected, as it could potentially put the child at further risk. Merely encouraging the child to be honest (Choice B) does not address the immediate safety concerns. Questioning the teacher (Choice C) is not the appropriate initial action when abuse is suspected; reporting to authorities should take precedence.

3. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:

• A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
• B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
• C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
• D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

Correct answer: C

Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.

4. A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?

• A. The mucous membrane is affected.
• B. The respiratory tract is affected.
• C. The skin is affected.
• D. The gastrointestinal tract is affected.

Correct answer: C

Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.

5. When communicating with a client who has cognitive impairment, which of the following will Nurse Dory use?

• A. Complete explanations with multiple details
• B. Pictures or gestures instead of words
• C. Stimulating words and phrases to capture the client’s attention
• D. Short words and simple sentences

Correct answer: D

Rationale: Nurse Dory will use short words and simple sentences when communicating with a client who has cognitive impairment. This approach is effective because it helps improve understanding and comprehension for individuals with cognitive challenges. Choice A is incorrect because complete explanations with multiple details may overwhelm or confuse clients with cognitive impairment. Choice B is not the most effective option as using pictures or gestures instead of words may not always be practical or necessary. Choice C is also not ideal as stimulating words and phrases may cause distraction rather than enhance communication for clients with cognitive impairment.

Similar Questions