Nursing Elites

1. The mother of a child with hepatitis A tells the home care nurse that she is concerned because the child's jaundice seems worse. What is the nurse's best response?

• A. You need to change the child's diet.
• B. The child probably is infectious again.
• C. The jaundice may worsen before it resolves.
• D. You need to call the primary health care provider.

Correct answer: C

Rationale: The best response for the nurse in this situation is to explain to the mother that jaundice may seem to worsen before it eventually gets better. This is a common occurrence in hepatitis A. Option A about changing the child's diet is irrelevant to the concern raised by the mother and not supported by evidence. Option B suggesting the child is infectious again is incorrect and may cause unnecessary alarm as jaundice does not indicate reinfection. Option D, advising the mother to call the primary health care provider, is premature as the nurse can first provide education and reassurance regarding the expected course of jaundice in hepatitis A.

2. A patient has come into the emergency room after an injury at work in which their upper body was pinned between two pieces of equipment. The nurse notes bruising in the upper abdomen and chest. The patient is complaining of sharp chest pain, having difficulty breathing, and their trachea is deviated to the left side. Which of the following conditions are these symptoms most closely associated with?

• A. Left-sided pneumothorax
• B. Pleural effusion
• C. Atelectasis
• D. Right-sided pneumothorax

Correct answer: D

Rationale: The patient is most likely suffering from a right-sided pneumothorax. Symptoms of a pneumothorax include sharp chest pain, difficulties with breathing, decreased vocal fremitus, absent breath sounds, and tracheal shift to the opposite of the affected side. In this case, the patient's trachea is deviated to the left side, indicating a right-sided pneumothorax. Choices A, B, and C can be eliminated as they do not present with the specific symptoms described in the scenario. Left-sided pneumothorax would not cause tracheal deviation to the left side. Pleural effusion typically presents with dull chest pain and decreased breath sounds, not sharp chest pain and tracheal deviation. Atelectasis would not cause tracheal deviation and is more associated with lung collapse rather than air accumulation in the pleural space.

3. An 85-year-old male has been losing mobility and gaining weight over the last two months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?

• A. CBC (complete blood count)
• B. ECG (electrocardiogram)
• C. Thyroid function tests
• D. CT scan

Correct answer: C

Rationale: The symptoms of weight gain and poor temperature tolerance in an elderly male suggest a potential thyroid dysfunction. Thyroid function tests are crucial in differentiating between hyperthyroidism, hypothyroidism, and a euthyroid state. These tests involve measuring the serum levels of thyroid hormones T3 and T4, also known as thyroxine, to evaluate thyroid function accurately. A complete blood count (Choice A) would not directly address the symptoms presented. An electrocardiogram (Choice B) assesses heart activity and would not be the primary test for these symptoms. A CT scan (Choice D) provides detailed images of internal organs and structures, which would not be the initial investigation for the described symptoms.

4. A patient is found unconscious in their room with rhythmic jerking of all four extremities and heavy foaming at the mouth. The patient was on seizure precautions with bedrails up and padded. What is the priority action for the nurse to take?

• A. Administer Lorazepam (Ativan)
• B. Turn the patient to his/her side
• C. Call the physician
• D. Suction the patient

Correct answer: B

Rationale: The nurse's priority action should be to turn the patient to his/her side. This position helps maintain an open airway and prevents aspiration of secretions or vomitus. Administering Lorazepam (Ativan) without ensuring a clear airway could lead to further complications. Calling the physician is important, but immediate interventions to protect the airway take precedence. Suctioning the patient may be necessary but should not be the initial action; positioning for airway protection is the priority.

5. A patient's chart indicates a history of meningitis. Which of the following would you NOT expect to see with this patient if this condition were acute?

• A. Increased appetite
• B. Vomiting
• C. Fever
• D. Poor tolerance of light

Correct answer: A

Rationale: The correct answer is 'Increased appetite.' In cases of acute meningitis, loss of appetite would be expected rather than an increase. Meningitis is often caused by an infectious agent that colonizes or infects various sites in the body, leading to systemic symptoms. Common symptoms of acute meningitis include fever, vomiting, and poor tolerance of light due to meningeal irritation. The inflammatory response in the meninges can result in symptoms like photophobia. Increased appetite is not typically associated with acute meningitis. Therefore, choice A is the least likely symptom to be observed in a patient with acute meningitis. Choices B, C, and D are symptoms commonly seen in acute meningitis due to the inflammatory process affecting the central nervous system and meninges.

Similar Questions