Nursing Elites

1. To prevent keratitis in an unconscious client, where should the nurse apply moisturizing ointment?

• A. Finger and toenail quicks
• B. Eyes
• C. Perianal area
• D. External ear canals

Correct answer: B

Rationale: The correct answer is B: Eyes. Applying moisturizing ointment to the eyes helps prevent keratitis, a condition that can occur due to inadequate blinking in unconscious clients, leading to corneal dryness and potential damage. Choices A, C, and D are incorrect as moisturizing ointment should not be applied to finger and toenail quicks, perianal area, or external ear canals to prevent keratitis.

2. The social ecological model considers the complex interplay between which levels of influence?

• A. Individual, interpersonal, organizational, community, and policy
• B. Genetic, biological, environmental, social, and economic
• C. Personal, family, community, national, and global
• D. Health, wealth, education, environment, and politics

Correct answer: A

Rationale: The correct answer is A: Individual, interpersonal, organizational, community, and policy. The social ecological model examines how individual, interpersonal, organizational, community, and policy factors interact to influence health and well-being. Choice B is incorrect because it includes genetic and biological factors that are not part of the social ecological model. Choice C is incorrect as it does not include organizational and policy levels of influence. Choice D is incorrect as it includes wealth and politics, which are not typically considered in the social ecological model.

3. What is a priority goal of involuntary hospitalization of the severely mentally ill client?

• A. Re-orientation to reality
• B. Elimination of symptoms
• C. Protection from harm to self or others
• D. Development of self-care skills

Correct answer: C

Rationale: The correct answer is C: 'Protection from harm to self or others.' Involuntary hospitalization is primarily aimed at ensuring the safety of the individual and others. Re-orientation to reality (choice A) may be a goal of treatment but not the primary goal of involuntary hospitalization. Elimination of symptoms (choice B) and development of self-care skills (choice D) are important aspects of treatment but are secondary to the immediate priority of ensuring safety in cases of severe mental illness.

4. 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.

5. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?

• A. ricin
• B. botulism toxin
• C. sulfur mustard
• D. yersinia pestis

Correct answer: B

Rationale: The correct answer is B: botulism toxin. Botulism toxin is associated with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, which are consistent with the client's presentation. Ricin (Choice A) typically presents with gastrointestinal symptoms. Sulfur mustard (Choice C) is a blistering agent causing skin, eye, and respiratory issues. Yersinia pestis (Choice D) is associated with the bubonic plague, presenting with fever, malaise, and buboes.

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