Nursing Elites

1. The client with multiple sclerosis is being educated by the nurse on exercises and physical activities. Which statement by the client indicates a need for further teaching?

• A. "I can lift weights and engage in resistance training."?
• B. "I should exercise until I am exhausted."?
• C. "I can incorporate aerobic exercises into my routine."?
• D. "I should perform proper stretching before starting my routine."?

Correct answer: B

Rationale: The correct answer is, "I should exercise until I am exhausted."? This statement indicates a need for further teaching because patients with multiple sclerosis should avoid exercising to the point of exhaustion or fatigue. Strenuous physical activity can increase body temperature and potentially worsen symptoms in individuals with multiple sclerosis. Choice A is correct because lifting weights and resistance training can be appropriate exercises for patients with multiple sclerosis. Choice C is valid because aerobic exercises can also be beneficial. Choice D is accurate as proper stretching before starting an exercise routine is essential for preventing injuries.

2. Mary T. was admitted to a nursing home on May 1st. On July 4th, she was diagnosed with a skin infection. This infection is considered a ________________ infection.

• A. nosocomial
• B. systemic
• C. resident flora
• D. resident aura

Correct answer: A

Rationale: The correct answer is 'nosocomial.' A nosocomial infection is defined as one that is not present upon admission to a healthcare facility but instead occurs during the patient's stay. In this case, since Mary was diagnosed with a skin infection after being admitted to the nursing home, it is considered a nosocomial infection. Nosocomial infections are a significant concern in healthcare settings, and infection control measures are in place to prevent their spread. Choices B, C, and D are incorrect. 'Systemic' refers to a condition affecting the entire body, not specific to a healthcare setting. 'Resident flora' and 'resident aura' are not commonly used terms in healthcare and do not relate to infections acquired in healthcare facilities.

3. Working in a clinic located in a community with many Hispanics, what strategy could the nurse implement to decrease health care disparities for Hispanic patients?

• A. Improve public transportation to the clinic.
• B. Update equipment and supplies at the clinic.
• C. Obtain low-cost medications for clinic patients.
• D. Teach clinic staff about Hispanic health beliefs.

Correct answer: D

Rationale: Health care disparities are primarily rooted in stereotyping, biases, and prejudice among healthcare providers. By educating clinic staff about Hispanic health beliefs, the nurse can help combat these issues, leading to improved cultural competency and patient care. Understanding the cultural context of Hispanic patients can enhance communication, trust, and treatment adherence. Improving public transportation, updating equipment, and obtaining low-cost medications are important aspects of healthcare delivery but do not directly address the underlying causes of health disparities experienced by Hispanic patients.

4. A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which group of the following medications would the patient most likely be started on?

• A. Aripiprazole (Abilify)
• B. Risperidone (Risperdal Consta)
• C. Fluphenazine (Prolixin)
• D. Fluoxetine (Prozac)

Correct answer: A

Rationale: In this scenario, where a patient without a history of psychiatric illness is experiencing psychotic symptoms like believing in poison letters, the most suitable medication group to start the patient on would be atypical antipsychotics. Aripiprazole (Abilify) belongs to this group and is preferred due to its efficacy with fewer side effects compared to conventional antipsychotics. Risperidone (Risperdal Consta) is also an atypical antipsychotic but is usually indicated after stabilizing the patient with oral medications. Fluphenazine (Prolixin) is a conventional antipsychotic, which is less favored due to its side effect profile. Fluoxetine (Prozac) is an antidepressant and is not the first-line treatment for psychotic symptoms.

5. Which of the following is an example of intrapersonal conflict?

• A. A nurse feels guilty when she administers essential medication that causes a client to have nausea and vomiting
• B. A nurse is called to testify in court about a client she cared for three years ago
• C. A nurse feels guilty for working overtime
• D. A nurse faces a conflict with a colleague over patient care decisions

Correct answer: A

Rationale: Intrapersonal conflict involves negative feelings or frustrations within oneself. It may be related to decisions or actions that clash with personal morals or beliefs. Choice A is the correct answer because the nurse is experiencing guilt due to administering medication that causes a client to have negative side effects, which reflects an internal struggle. Choices B, C, and D do not represent intrapersonal conflict. Choice B involves a legal obligation, Choice C is related to external factors like working overtime, and Choice D pertains to a conflict with a colleague.

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