Nursing Elites

1. A patient has been diagnosed with diabetes mellitus. Which of the following is not a clinical sign of diabetes mellitus?

• A. Polyphagia
• B. Polyuria
• C. Metabolic acidosis
• D. Lower extremity edema

Correct answer: D

Rationale: Polyphagia, polyuria, and metabolic acidosis are common clinical signs of diabetes mellitus. Polyphagia refers to excessive hunger, polyuria is excessive urination, and metabolic acidosis can occur due to poorly controlled diabetes. Lower extremity edema, on the other hand, is not a typical clinical sign of diabetes mellitus. Edema in the lower extremities is more commonly associated with conditions like heart failure or kidney disease rather than diabetes mellitus.

2. Teaching the client with gonorrhea how to prevent reinfection and further spread is an example of

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. primary health care prevention

Correct answer: B

Rationale: The correct answer is B: secondary prevention. This type of prevention focuses on reducing the impact of a disease by early detection and treatment. In the case of gonorrhea, teaching the client how to prevent reinfection and further spread falls under secondary prevention because it aims to reduce the prevalence and morbidity of the disease. Choice A (primary prevention) involves measures to prevent the disease from occurring in the first place, such as vaccination. Choice C (tertiary prevention) focuses on managing the long-term consequences of a disease to prevent complications. Choice D (primary health care prevention) is not a recognized term in prevention strategies.

3. A client has chronic respiratory acidosis caused by end-stage chronic obstructive pulmonary disease (COPD). Oxygen is delivered at 1 L/min via nasal cannula. The nurse teaches the family that the reason for this is to avoid respiratory depression, based on which of the following explanations?

• A. COPD clients are stimulated to breathe by hypoxia.
• B. COPD clients depend on a low carbon dioxide level.
• C. COPD clients tend to retain hydrogen ions if they are given high doses of oxygen.
• D. COPD clients thrive on a high oxygen level.

Correct answer: A

Rationale: In clients with COPD and chronic respiratory acidosis, they are compensating for low oxygen and high carbon dioxide levels. Hypoxia acts as the main stimulus to breathe in individuals with chronic hypercapnia. When oxygen is administered, it can decrease the respiratory drive by eliminating the hypoxic drive and reducing the stimulus to breathe. Therefore, delivering oxygen at 1 L/min via nasal cannula helps prevent respiratory depression by maintaining the hypoxic drive to breathe. The other options are incorrect: COPD clients do not depend on a low carbon dioxide level as they are chronically hypercapnic, they do not retain hydrogen ions with high oxygen doses, and they do not thrive on a high oxygen level.

4. Which instruction should be given in a health education class regarding testicular cancer?

• A. All males should perform a testicular exam after a warm bath or shower.
• B. Testicular exams should be performed on a daily basis.
• C. Reddening or darkening of the scrotum is a normal finding.
• D. Testicular exams should be performed after a warm bath or shower.

Correct answer: D

Rationale: The correct instruction for testicular cancer education is that testicular exams should be performed after a warm bath or shower as it relaxes the scrotum and makes the exam easier. Testicular exams should be done monthly by all men starting around age 15, not after the age of 30 (Choice A) or on a daily basis (Choice B), which is unnecessary and may lead to unnecessary anxiety. Reddening or darkening of the scrotum is not a normal finding (Choice C) and should be reported to a healthcare provider for further evaluation.

5. A 32-year-old male with a complaint of dizziness has an order for Morphine via IV. What should the nurse do first?

• A. Check the patient's chest x-ray results.
• B. Retake vitals including blood pressure.
• C. Perform a neurological screening on the patient.
• D. Request the physician on-call to assess the patient.

Correct answer: B

Rationale: The correct first action for the nurse to take in this situation is to retake the patient's vitals, including blood pressure. Dizziness can be a sign of hypotension, which may be a contraindication for administering Morphine. Checking the chest x-ray results (Choice A) would not be the priority in this case as addressing the dizziness is more urgent. Performing a neurological screening (Choice C) may be important but not the first step when a patient presents with dizziness and an order for Morphine. Requesting the physician to assess the patient (Choice D) should come after the initial assessment and vitals retake.

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