Nursing Elites

1. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, “We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk.” How should the nurse respond to this family's concerns?

• A. “Vaccinations are not without some risks, but these are far exceeded by the potential benefits they offer in preventing serious diseases.”
• B. “The potential risks of vaccinations have been investigated and determined to be minimal compared to the benefits of protecting your child from potentially life-threatening diseases.”
• C. “It is important to follow state laws regarding vaccines, but I understand your concerns. Let's discuss the specific risks and benefits of vaccines for your child.”
• D. “Vaccines indeed cause several serious adverse effects, but these are usually treated effectively, and the benefits of vaccination in preventing diseases far outweigh the risks.”

Correct answer: B

Rationale: When addressing concerns about vaccination, it is crucial to provide accurate information to help parents make informed decisions. Choice B is the most appropriate response as it acknowledges the concerns of the family while emphasizing that the potential risks of vaccinations are minimal compared to the significant benefits of protecting the child from serious diseases. This response shows empathy towards the parents' concerns while also highlighting the importance of vaccination in preventing life-threatening illnesses. Choice A is incorrect because it does not emphasize the significant benefits of vaccination in preventing diseases, which may not effectively address the family's concerns. Choice C is incorrect as it focuses more on state laws rather than addressing the family's specific concerns about vaccine safety. Choice D is incorrect as it may increase the family's anxiety by highlighting adverse effects without adequately emphasizing the benefits of vaccination in disease prevention.

2. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:

• A. Malnutrition
• B. Free radicals
• C. Ischemia
• D. Chemical toxicity

Correct answer: C

Rationale: The correct answer is C: Ischemia. In this scenario, the 75-year-old male experiences chest pain on exertion, which is indicative of angina. Angina is primarily caused by reduced blood flow to the heart muscle, leading to hypoxic injury. This condition is known as ischemia. Options A, B, and D are incorrect. Malnutrition does not typically cause chest pain related to exertion. Free radicals and chemical toxicity are not common causes of chest pain in the context described. Therefore, the most likely cause of chest pain in this case is ischemia due to reduced blood flow.

3. What assessment is the nurse performing when a client is asked to stand with feet together, eyes open, and hands by the sides, and then asked to close the eyes while the nurse observes for a full minute?

• A. Romberg test
• B. Weber test
• C. Rinne test
• D. Babinski test

Correct answer: A

Rationale: The correct answer is A, Romberg test. The Romberg test is used to assess balance and proprioception. During the test, the client is asked to stand with feet together, eyes open, and hands by the sides to observe their balance. Then, the client is asked to close their eyes while the nurse continues to observe for a full minute. This test helps in detecting any issues with proprioception and balance, which may be compromised in conditions affecting the nervous system. Choices B, C, and D are incorrect because the Weber test is used to assess hearing in each ear, the Rinne test is used to compare air and bone conduction of sound, and the Babinski test is used to assess the integrity of the corticospinal tract.

4. Why is testosterone therapy prescribed for a 70-year-old man being treated for osteoporosis?

• A. To increase bone density
• B. To reduce the risk of fractures
• C. To enhance sexual performance
• D. To restore testosterone levels

Correct answer: D

Rationale: The primary reason for prescribing testosterone therapy for osteoporosis in men is to restore testosterone levels, not specifically to increase bone density. Testosterone plays a crucial role in maintaining bone density, so by restoring testosterone levels, it indirectly helps in maintaining bone density. Choices A and B are partially correct but do not address the primary reason for testosterone therapy in this context. Choice C is incorrect as the main focus of testosterone therapy in osteoporosis treatment is not related to enhancing sexual performance.

5. What signs and symptoms most likely prompted this patient to initially seek care?

• A. Malaise and fatigue
• B. Severe diarrhea
• C. Intermittent fever
• D. Dizziness and confusion

Correct answer: B

Rationale: The correct answer is B: Severe diarrhea. A patient who has recently returned from a trip to Nepal with a nongovernmental organization and is seeking care for amebiasis would most likely have been prompted by the symptom of severe diarrhea. Amebiasis is an infection caused by the parasite Entamoeba histolytica, commonly transmitted through contaminated food or water sources in developing countries like Nepal. The hallmark symptom of amebiasis is dysentery, which is characterized by severe diarrhea with blood or mucus in the stool. Malaise and fatigue (choice A) are nonspecific symptoms that may accompany many illnesses and are not specific to amebiasis. Intermittent fever (choice C) is not a typical presenting symptom of amebiasis, which primarily manifests with gastrointestinal symptoms. Dizziness and confusion (choice D) are also not typical symptoms associated with amebiasis.

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