Nursing Elites

1. The nurse is caring for a 75-year-old client in congestive heart failure. Which finding suggests that digitalis levels should be reviewed?

• A. Extreme fatigue
• B. Increased appetite
• C. Intense itching
• D. Constipation

Correct answer: A

Rationale: Extreme fatigue can be a sign of digitalis toxicity, especially in older adults, and warrants a review of the client's medication levels and potential adjustment. Increased appetite, intense itching, and constipation are not typically associated with digitalis toxicity and do not directly indicate a need for a review of digitalis levels.

2. In the provision of preventive care to workers, the nurse must be aware of biological hazards that are harmful to workers and their families, such as:

• A. bacteria, fungi, and insects
• B. noise
• C. toxic metals, poisonous gas fumes, and dust
• D. stress

Correct answer: A

Rationale: The correct answer is A: bacteria, fungi, and insects. Biological hazards in the workplace can include microorganisms like bacteria and fungi that can cause infections, as well as insects that may carry diseases. Noise (choice B) is considered a physical hazard, not a biological one. Toxic metals, poisonous gas fumes, and dust (choice C) are examples of chemical hazards, not biological hazards. While stress (choice D) can be a health concern in the workplace, it is not classified as a biological hazard.

3. A nurse is preparing to administer a tuberculosis (TB) test to a client. Which of the following is the correct method for administering this test?

• A. Intradermal injection on the forearm
• B. Subcutaneous injection on the upper arm
• C. Intramuscular injection on the deltoid
• D. Oral administration

Correct answer: A

Rationale: The correct method for administering a tuberculosis (TB) test is through an intradermal injection on the forearm. This technique allows for the proper administration of the test under the skin to assess the body's response to the TB antigen. Choices B, C, and D are incorrect because the TB test specifically requires an intradermal injection, not subcutaneous, intramuscular, or oral administration.

4. Which of the following patients should the home care nurse assess first?

• A. A 65-year-old male with known COPD and difficulty breathing after climbing a flight of stairs.
• B. A 78-year-old with CHF who has gained 4 lbs according to her tele-monitoring.
• C. A 50-year-old with bilateral leg swelling and difficulty walking.
• D. A 60-year-old with lower back pain.

Correct answer: A

Rationale: The correct answer is A. A patient with known COPD and difficulty breathing after physical exertion like climbing stairs requires immediate assessment by the nurse. This could indicate a potential exacerbation of COPD, which needs prompt intervention to prevent respiratory distress. Choices B, C, and D describe important patient situations that also require attention, but the urgency is higher with a COPD patient experiencing difficulty breathing.

5. A nurse is planning a nutrition class for a group of senior citizens at a community center and wants to emphasize the amount and types of fat in some foods versus others. What is the best teaching method for the nurse to use?

• A. Display posters with foods and inform seniors about fat content.
• B. Determine the foods most often eaten by this group and discuss the nutritional panel of each product.
• C. Show a movie about cooking with foods that are low in fat but delicious.
• D. Ask each senior to bring a food for others to taste, then estimate the fat content in these foods.

Correct answer: B

Rationale: The best teaching method for the nurse in this scenario is to determine the foods most often eaten by the group and discuss the nutritional panel of each product. This approach directly educates the seniors about the fat content in the foods they commonly consume, making the information more relevant and applicable to their daily lives. Choice A, displaying posters with foods, may not engage the seniors effectively or provide detailed information about fat content. Choice C, showing a movie about cooking with low-fat foods, may not address the specific fat content of the seniors' usual food choices. Choice D, asking seniors to bring foods for tasting and estimating fat content, could be subjective and less educational compared to discussing concrete nutritional information from food labels.

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