Nursing Elites

1. A test that can correctly identify those who do not have a given disease is:

• A. specific.
• B. sensitive.
• C. negative culture.
• D. marginal finding.

Correct answer: A

Rationale: The correct answer is 'specific.' A specific test correctly identifies individuals who do not have a particular disease. In this case, since the lab culture report is negative for the suspected infection, it means the test is good at ruling out the disease. 'Sensitive' (choice B) would be incorrect as sensitivity refers to a test's ability to correctly identify individuals who do have the disease. 'Negative culture' (choice C) is incorrect as it describes the result rather than the test's characteristic. 'Marginal finding' (choice D) is unrelated to the concept of correctly identifying individuals without the disease.

2. A nurse is planning client assignments for the day. Which task should the nurse assign to the nursing assistant (unlicensed assistive personnel)?

• A. Recording the urinary output for a client with renal calculi whose urine must be strained
• B. Dressing change instructions for a client who had a mastectomy 2 days ago
• C. Reporting abnormal lab values to the health care provider for a client scheduled for a laparoscopic cholecystectomy
• D. Preprocedural teaching for a client scheduled for a cardiac stress test

Correct answer: A

Rationale: The nurse is legally responsible for client assignments and must assign tasks based on state nursing practice act guidelines and job descriptions provided by the employing agency. The nursing assistant is trained to measure, collect, and strain urine, making recording urinary output for a client with renal calculi a suitable task for the nursing assistant. This task falls within the nursing assistant's role description. Dressing change instructions for a client who had a mastectomy involve a higher level of skill and knowledge, beyond the scope of a nursing assistant. Reporting abnormal lab values to the health care provider for a client scheduled for a laparoscopic cholecystectomy requires interpretation and clinical judgment, which is typically not within the nursing assistant's role. Preprocedural teaching for a client scheduled for a cardiac stress test involves providing detailed information and education, which is usually the responsibility of a licensed nurse or other qualified healthcare provider.

3. What dietary alterations should a pregnant client with congenital heart disease expect?

• A. reduced calories and reduced fat
• B. caffeine and sodium restrictions
• C. decreased protein and increased complex carbohydrates
• D. fluid restriction and reduced calories

Correct answer: B

Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.

4. At what point in the nurse-client relationship should termination first be addressed?

• A. in the working phase
• B. in the termination phase
• C. in the orientation phase
• D. when the client initially brings up the topic

Correct answer: C

Rationale: Termination in the nurse-client relationship should first be addressed in the orientation phase. This is because the client has a right to know the parameters of the relationship from the beginning. During the orientation phase, it is important to discuss if the relationship is time-limited, inform the client about the number of sessions, or explain that it is open-ended with the termination date to be negotiated later. Addressing termination in the orientation phase helps establish transparency and clear communication. Choices A, B, and D are incorrect because termination discussions should ideally start at the beginning of the relationship to set appropriate expectations.

5. A client is diagnosed with HIV. Which of the following antiviral drug classes are used in the treatment of HIV/AIDS?

• A. nucleoside reverse transcriptase inhibitors
• B. protease inhibitors
• C. HIV fusion inhibitors
• D. all of the above

Correct answer: D

Rationale: All of the provided choices are antiviral drug classes used in the treatment of HIV/AIDS. Nucleoside reverse transcriptase inhibitors, such as tenofovir and emtricitabine, work by interfering with the virus's ability to replicate. Protease inhibitors, like atazanavir and darunavir, block an enzyme that HIV needs to make copies of itself. HIV fusion inhibitors, for instance, enfuvirtide, prevent HIV from entering human cells. Therefore, 'all of the above' is the correct answer as all the listed drug classes are commonly used in managing HIV infections. Choices A, B, and C are all essential components of antiretroviral therapy for HIV, targeting different stages of the virus's life cycle. The combination of drugs from these classes is often recommended to effectively control HIV replication and reduce viral load.

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