Nursing Elites

1. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

2. In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called:

• A. Aphasia.
• B. Agnosia.
• C. Sundowning.
• D. Confabulation.

Correct answer: C

Rationale: The correct answer is C: Sundowning. Sundowning is a phenomenon where individuals with cognitive impairment experience increased confusion and agitation in the late afternoon or early evening. This often occurs in conditions like dementia. Choice A, Aphasia, refers to a language disorder affecting a person's ability to communicate. Choice B, Agnosia, is the inability to recognize objects. Choice D, Confabulation, is the production of false memories without the intention to deceive, often seen in conditions like Korsakoff's syndrome.

3. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

• A. It usually occurs with a headache.
• B. Pupillary changes are common.
• C. It is usually triggered when the patient bends forward.
• D. Nystagmus continues even when the eyes fixate on an object.

Correct answer: C

Rationale: The correct answer is C: 'It is usually triggered when the patient bends forward.' Benign positional vertigo is often triggered by changes in head position, such as bending forward. Choices A, B, and D are incorrect. A is incorrect because benign positional vertigo is not typically associated with headaches. B is incorrect because pupillary changes are not a common feature of benign positional vertigo. D is incorrect because nystagmus in benign positional vertigo usually stops when the eyes fixate on an object.

4. In a patient with a subconjunctival hemorrhage due to allergic rhinitis, which statement is accurate?

• A. The hemorrhage will resolve without treatment within 2 weeks.
• B. The patient should be referred for immediate ophthalmologic examination.
• C. Oral antihistamines should be started to prevent further complications.
• D. Topical corticosteroids may be considered to reduce inflammation.

Correct answer: A

Rationale: In a patient with a subconjunctival hemorrhage secondary to allergic rhinitis, the hemorrhage is typically self-limiting and will resolve on its own within 2 weeks without the need for specific treatment. Referring the patient for immediate ophthalmologic examination is not necessary unless there are other concerning symptoms. Starting oral antihistamines may help manage the underlying allergic rhinitis but is not specifically indicated for the hemorrhage. Topical corticosteroids are not routinely prescribed for subconjunctival hemorrhage as they may have limited benefit and could potentially cause complications.

5. Which electrolyte imbalance does the nurse suspect in a patient with hyperaldosteronism?

• A. Hyponatremia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: C

Rationale: In a patient with hyperaldosteronism, the nurse would suspect hyperkalemia. Hyperaldosteronism leads to increased potassium excretion, resulting in low potassium levels in the blood. Therefore, choices A (Hyponatremia), B (Hypernatremia), and D (Hypercalcemia) are incorrect. Hyponatremia refers to low sodium levels, Hypernatremia refers to high sodium levels, and Hypercalcemia refers to high calcium levels, none of which are typically associated with hyperaldosteronism.

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