Nursing Elites

1. The nurse is assigned to a client with Parkinson's disease. Which findings would the nurse anticipate?

• A. Non-intention tremors and urgency with voiding
• B. Echolalia and a shuffling gait
• C. Muscle spasm and a bent-over posture
• D. Intention tremor and jerky movement of the elbows

Correct answer: B

Rationale: The correct answer is B. Echolalia (repeating others' words) and a shuffling gait are common symptoms of Parkinson's disease. These symptoms result from the degeneration of the basal ganglia in the brain that controls movement and speech. Choice A is incorrect because non-intention tremors are not typically associated with Parkinson's disease. Choice C is incorrect as muscle spasm and a bent-over posture are not classic manifestations of Parkinson's disease. Choice D is incorrect since intention tremors and jerky movement of the elbows are not characteristic of Parkinson's disease.

2. The nurse is preparing an orientation class for new employees at an inner city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?

• A. A lack of transportation is a major barrier for the clinic's clients.
• B. Basic physiologic needs are likely to be unmet in this clinic's client population.
• C. Printed material is less effective for this population with limited reading skills.
• D. Group education classes are often poorly attended by non-compliant clients.

Correct answer: B

Rationale: The correct answer is B because addressing basic physiologic needs is crucial for low-income populations. Ensuring that basic needs such as food, shelter, and safety are met is essential for these clients to engage effectively in their healthcare. Choice A talks about transportation, which can be a barrier but may not be the major impediment. Choice C focuses on printed material and reading skills, which are important but not as fundamental as addressing basic physiologic needs. Choice D makes assumptions about client attendance based on compliance, which is not the most critical information to include in an orientation about serving a low-income population.

3. A 16-year-old client is admitted to a psychiatric unit with a diagnosis of attempted suicide. The nurse is aware that the most frequent cause for suicide in adolescents is

• A. Progressive failure to adapt
• B. Feelings of anger or hostility
• C. Reunion wish or fantasy
• D. Feelings of alienation or isolation

Correct answer: D

Rationale: Feelings of alienation or isolation are common triggers for suicidal behavior in adolescents. This sense of being disconnected or isolated from others can lead to despair and hopelessness, increasing the risk of suicidal ideation. Choices A, B, and C are less commonly associated with suicide in adolescents. Progressive failure to adapt may contribute to stress, but it is not typically the primary cause of suicide. Feelings of anger or hostility, while negative emotions, do not always lead to suicidal behavior in adolescents. Reunion wish or fantasy is not a recognized primary cause of suicide in this age group.

4. Which organization is primarily responsible for global public health?

• A. World Health Organization (WHO)
• B. Centers for Disease Control and Prevention (CDC)
• C. National Institutes of Health (NIH)
• D. United Nations (UN)

Correct answer: A

Rationale: The correct answer is A: World Health Organization (WHO). The WHO is the primary organization responsible for global public health initiatives, coordinating international health efforts, setting norms and standards, providing technical support, and monitoring health trends. Choices B, C, and D are incorrect because while they play significant roles in health and global affairs, they do not have the primary responsibility for global public health like the WHO does.

5. You are teaching a client about the patient-controlled analgesia (PCA) planned for post-operative care. Which statement indicates further teaching may be needed by the client?

• A. ''I will be receiving continuous doses of medication.''
• B. ''I should call the nurse before I take additional doses.''
• C. ''I will call for assistance if my pain is not relieved.''
• D. ''The machine will prevent an overdose.''

Correct answer: B

Rationale: PCA allows patients to self-administer pain medication within prescribed limits, without the need to call the nurse before taking an additional dose. Choice B suggests a misunderstanding of how PCA works, as the patient should be educated that they can self-administer doses within the safety parameters set by the healthcare provider. Choices A, C, and D demonstrate proper understanding of PCA, hence are not indicative of needing further teaching.

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