Nursing Elites

1. The nurse is providing care for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment finding requires immediate intervention?

• A. Serum sodium of 140 mEq/L.
• B. Serum osmolality of 280 mOsm/kg.
• C. Weight gain of 2 pounds in 24 hours.
• D. Serum sodium of 130 mEq/L.

Correct answer: D

Rationale: The corrected answer is D. A serum sodium level of 130 mEq/L indicates hyponatremia, which requires immediate intervention in a client with SIADH. Hyponatremia can lead to serious complications such as seizures, coma, and cerebral edema. Choices A, B, and C are not the most critical findings in a client with SIADH. While a serum sodium of 140 mEq/L is within the normal range, a decrease to 130 mEq/L is concerning and requires prompt action to prevent complications.

2. A client who has active tuberculosis (TB) is admitted to the medical unit. What action is most important for the nurse to implement?

• A. Wear a gown and gloves.
• B. Have the client wear a mask.
• C. Perform hand hygiene.
• D. Assign the client to a negative air-flow room.

Correct answer: D

Rationale: The correct answer is to assign the client to a negative air-flow room (Choice D). Active tuberculosis requires implementation of airborne precautions, including isolating the client in a negative pressure air-flow room to prevent the spread of the infection to others. Choice A (Wear a gown and gloves) is important for standard precautions but does not address the specific airborne precautions needed for tuberculosis. Choice B (Have the client wear a mask) may help reduce the spread of respiratory droplets but does not provide adequate protection for healthcare workers or other patients. Choice C (Perform hand hygiene) is essential for infection control but is not the most critical action when dealing with an airborne infection like tuberculosis.

3. Following a blizzard that resulted in millions of dollars of damage, the community health nurse is planning to seek financial assistance for families affected by the disaster. Which contact is most important for the nurse to make?

• A. the governor's disaster relief program
• B. Federal Emergency Management Agency (FEMA)
• C. local churches that can provide shelter
• D. the community to seek volunteer contributions

Correct answer: B

Rationale: The correct answer is B, the Federal Emergency Management Agency (FEMA). FEMA is the primary agency responsible for providing financial assistance and support during disasters. While the governor's disaster relief program may also offer help, FEMA has more extensive resources and expertise in disaster response. Local churches providing shelter and seeking volunteer contributions from the community are valuable resources but may not offer the comprehensive financial assistance that FEMA can provide in such situations.

4. The healthcare provider is caring for a client with a urinary tract infection. Which finding requires immediate intervention?

• A. Dysuria.
• B. Hematuria.
• C. Fever.
• D. Urinary frequency.

Correct answer: C

Rationale: Fever can indicate a severe infection, such as pyelonephritis, in a client with a urinary tract infection and requires immediate intervention. Hematuria and dysuria are common symptoms of a urinary tract infection but may not always require immediate intervention unless severe. Urinary frequency is also a common symptom and does not indicate the severity of the infection as fever does.

5. A male client leaves his job at a nearby restaurant and visits the health clinic where he is diagnosed with viral conjunctivitis. While receiving discharge instructions from the nurse, the client states that he is feeling much better and plans to return to work for the afternoon shift. How should the nurse respond?

• A. advise the client to wear a face mask around other people
• B. ask the client what type of work he does at the restaurant
• C. instruct the client to use dark glasses if lighting is bright
• D. explain that the client should stay home for the next few days

Correct answer: D

Rationale: The correct answer is D: explain that the client should stay home for the next few days. Viral conjunctivitis is highly contagious, and the client should avoid close contact with others until it resolves. Returning to work while still contagious can lead to the spread of the infection to coworkers and customers. Choice A is incorrect because wearing a face mask may not provide sufficient protection against spreading the virus in a close work environment. Choice B is irrelevant to the situation as the focus should be on the client's health and preventing the spread of the infection. Choice C is also unrelated to the management of viral conjunctivitis and does not address the contagious nature of the condition.

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