Nursing Elites

1. A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?

• A. A 17-year-old who is sexually active with numerous partners.
• B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
• C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
• D. A 34-year-old male homosexual who is in a monogamous relationship.

Correct answer: A

Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.

2. During a visit to the community health clinic, a 45-year-old Native American female, who has a BMI of 35, complains of changes in her vision. Which condition is most important for the RN to be aware of in the client's family history?

• A. Diabetes
• B. Glaucoma
• C. Hypertension
• D. Brain Tumor

Correct answer: A

Rationale: The correct answer is A: Diabetes. Given the client's Native American ethnicity, high BMI, and vision changes, diabetes is the most crucial condition for the nurse to be aware of in the client's family history. Diabetes is strongly associated with vision problems, especially diabetic retinopathy. Glaucoma (choice B) is a condition that affects the optic nerve and can lead to vision loss but is not as directly linked to the client's BMI and ethnic background. Hypertension (choice C) can also impact vision, but in this case, diabetes takes precedence based on the client's profile. Brain tumor (choice D) is less likely to be related to the client's BMI, ethnicity, and vision changes compared to diabetes.

3. Which of the following measures the frequency of new cases of the phenomenon during a given period of time?

• A. prevalence rate
• B. proportionate mortality rate
• C. case fatality rate
• D. incidence rate

Correct answer: D

Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.

4. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse should monitor the client for which of the following side effects?

• A. Constipation
• B. Hypertension
• C. Muscle weakness
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis, can lead to bradycardia as a side effect. Choice A, constipation, is not a common side effect of pyridostigmine. Choice B, hypertension, is unlikely as pyridostigmine is more likely to cause hypotension. Choice C, muscle weakness, is actually a symptom of myasthenia gravis itself and not a side effect of pyridostigmine.

5. The nurse is teaching a group of older adults about medication safety. Which of the following should be included in the teaching?

• A. keeping a list of all medications and dosages
• B. sharing medications with family members if they have the same prescription
• C. stopping medications when symptoms improve
• D. doubling up on missed doses

Correct answer: A

Rationale: The correct answer is A: keeping a list of all medications and dosages. Maintaining a comprehensive list of medications and their dosages is essential for older adults to prevent medication errors and dangerous interactions. Choice B is incorrect because sharing medications, even if family members have the same prescription, can lead to unintended adverse effects or inappropriate dosages. Choice C is incorrect as stopping medications when symptoms improve can be harmful if the full course of treatment is not completed. Choice D is incorrect as doubling up on missed doses can result in overdosing and adverse reactions.

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