Nursing Elites

1. 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.

2. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

3. A senior high school student, whose immunization status is current, asks the school nurse which immunizations will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive?

• A. Hepatitis C (HepC)
• B. Influenza type B (HIB)
• C. Measles, mumps, rubella (MMR)
• D. Diphtheria, tetanus, pertussis (DTaP)

Correct answer: C

Rationale: The correct answer is C: Measles, mumps, rubella (MMR). MMR vaccine is commonly included in precollege physicals to ensure students are protected against these diseases. Choice A, Hepatitis C (HepC), is incorrect as the standard vaccine for hepatitis given in childhood is Hepatitis B. Choice B, Influenza type B (HIB), is not typically administered during precollege physicals but is recommended for younger children. Choice D, Diphtheria, tetanus, pertussis (DTaP), is usually given in early childhood and not typically repeated during precollege physicals.

4. The healthcare provider is screening children at a local community health clinic for infectious diseases. Which child is at the highest risk for hepatitis B virus?

• A. a newborn
• B. a 3-year-old
• C. a 7-year-old
• D. an 11-year-old

Correct answer: A

Rationale: Newborns are at the highest risk for hepatitis B virus due to potential transmission from the mother. The hepatitis B virus can be transmitted from an infected mother to her baby during childbirth. Children born to mothers infected with hepatitis B are at the highest risk of acquiring the infection. Choices B, C, and D are at lower risk compared to a newborn as they are less likely to have been exposed to the virus during childbirth.

5. You attended a home delivery with the Rural Health midwife. The newborn is premature. Which of the following should be included in premature infant care at home?

• A. establishing and maintaining good respiration
• B. proper management of feeding
• C. minimum handling of the baby
• D. regulation of body temperature

Correct answer: D

Rationale: Corrected Rationale: Regulation of body temperature is crucial for the survival of a premature infant. Premature infants have difficulty regulating their body temperature, making it essential to keep them warm. While establishing and maintaining good respiration and proper feeding management are important aspects of infant care, they are not as critical as regulating body temperature for premature infants. Additionally, while minimizing handling to reduce stress can be beneficial, it is not as vital as temperature regulation for premature infants.

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