Nursing Elites

1. Which of the following conditions has a severe complication of respiratory failure?

• A. Bell's palsy
• B. Guillain-Barr� syndrome
• C. Trigeminal neuralgia
• D. Tetanus

Correct answer: B

Rationale: Guillain-Barr� syndrome is characterized by a severe complication of respiratory failure due to the involvement of the peripheral nerves that control breathing. While Bell's palsy, trigeminal neuralgia, and tetanus are also conditions affecting peripheral nerves, they do not typically lead to respiratory failure like Guillain-Barr� syndrome. Bell's palsy causes facial muscle weakness, trigeminal neuralgia results in severe facial pain, and tetanus leads to muscle stiffness and spasms, but none of these conditions directly involve respiratory failure.

2. If a visitor accidentally knocks over a plastic pleural drainage system connected to a client, causing it to crack, what should the nurse do first?

• A. Observe the client's response.
• B. Notify the physician.
• C. Change the drainage system.
• D. Observe for leaks.

Correct answer: C

Rationale: When a pleural drainage system is cracked, the nurse's initial action should be to change the drainage system. This is essential to prevent potential complications like air leaks or infections. While observing the client's response and checking for leaks are important steps, they are secondary to addressing the immediate issue of the cracked system. Notifying the physician, though necessary, can be carried out once the primary concern of the damaged system is resolved.

3. A nurse is planning task assignments for the day. Which assignment is the least appropriate for the nursing assistant?

• A. Assisting a client with dysphagia in eating
• B. Ambulating a client with Parkinson's disease
• C. Providing hygiene to a client with dementia
• D. Assisting a client with an above-the-knee amputation in showering

Correct answer: A

Rationale: The least appropriate assignment for a nursing assistant would be assisting a client with dysphagia in eating. This task requires specialized skills and knowledge to prevent complications such as choking and aspiration. Ambulating a client with Parkinson's disease, providing hygiene to a client with dementia, and assisting a client with an above-the-knee amputation in showering are tasks that a nursing assistant can safely perform without significant risk of complications. Assisting a client with dysphagia in eating involves higher risks and requires specific training, making it the least appropriate choice for a nursing assistant.

4. All of the following interventions should be performed when fetal heart monitoring indicates fetal distress except:

• A. Increase maternal fluids.
• B. Administer oxygen.
• C. Decrease maternal fluids.
• D. Turn the mother.

Correct answer: C

Rationale: When fetal heart monitoring indicates fetal distress, interventions are aimed at improving oxygenation to the fetus. Increasing maternal fluids helps improve placental perfusion and oxygen delivery to the fetus. Administering oxygen also aids in increasing oxygen supply to the fetus. Turning the mother can help relieve pressure on the vena cava, optimizing blood flow to the placenta. Therefore, decreasing maternal fluids would not be performed as it can further compromise placental perfusion and fetal oxygenation, making it the exception. Decreasing maternal fluids could potentially exacerbate fetal distress by reducing oxygen delivery and nutrient supply to the fetus, which is contrary to the goal of managing fetal distress.

5. Which of the following is responsible for laws mandating the reporting of certain infections and diseases?

• A. Centers for Disease Control and Prevention (CDC)
• B. individual state laws
• C. National Institutes of Health (NIH)
• D. Health and Human Services (HHS)

Correct answer: B

Rationale: Individual state laws mandate the reporting of infectious diseases. The list of reportable diseases varies from state to state and is overseen by state health departments. While the CDC plays a significant role in disease surveillance, reporting infectious diseases is primarily governed by individual state laws. The CDC's role is to provide support, guidance, and expertise to state health departments. The National Institutes of Health (NIH) primarily focus on biomedical and health-related research, not on mandating disease reporting. Health and Human Services (HHS) is a federal department that oversees various agencies, but the responsibility for mandating disease reporting lies with individual states.

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