Nursing Elites

1. What is the most common cause of dementia among elderly persons?

• A. Parkinson’s disease
• B. Multiple sclerosis
• C. Amyotrophic lateral sclerosis (Lou Gehrig’s disease)
• D. Alzheimer’s disease

Correct answer: D

Rationale: Alzheimer’s disease is the most common cause of dementia among elderly persons. It is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. While Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis are serious conditions, they are not typically associated with dementia in the same way Alzheimer’s disease is. Therefore, the correct answer is D.

2. Which action would break sterile technique while preparing a sterile field for a dressing change?

• A. Using sterile forceps instead of sterile gloves to handle a sterile item
• B. Touching the outside wrapper of sterilized material without sterile gloves
• C. Placing a sterile object at the edge of the sterile field
• D. Pouring out a small amount of solution (15 to 30 ml) before pouring it into a sterile container

Correct answer: B

Rationale: Touching the outside wrapper of sterilized material without sterile gloves can introduce contaminants and compromise the sterility of the item. It is crucial to maintain strict adherence to sterile technique to prevent infections and ensure patient safety during procedures.

3. A client with active tuberculosis is prescribed isoniazid, rifampin, pyrazinamide, and ethambutol. Which statement by the client indicates an understanding of the teaching?

• A. I can substitute one medication for another if I run out because they all fight infection.
• B. I will wash my hands each time I cough.
• C. I am glad I don't have to have any more sputum specimens.
• D. I don't need to worry about where I go once I start taking my medications.

Correct answer: B

Rationale: The correct statement indicating understanding of tuberculosis medication regimen is 'I will wash my hands each time I cough.' This statement shows knowledge of infection control practices to prevent the spread of tuberculosis. Washing hands after coughing helps in reducing the transmission of the disease to others. The other options are incorrect. Option A is incorrect as each medication in the regimen has a specific role, and substituting one for another can compromise the effectiveness of treatment. Option C is incorrect as obtaining sputum specimens is essential for monitoring treatment response. Option D is incorrect as the client should still adhere to infection control measures and avoid exposing others to tuberculosis.

4. A client with depression reports taking St. John's wort along with citalopram. The nurse should monitor the client for which of the following conditions as a result of an interaction between these substances?

• A. Serotonin syndrome
• B. Tardive dyskinesia
• C. Pseudoparkinsonism
• D. Acute dystonia

Correct answer: A

Rationale: When St. John's wort, an herbal supplement, is taken with citalopram, a selective serotonin reuptake inhibitor (SSRI), there is a risk of serotonin syndrome. Serotonin syndrome is a serious condition that can occur when there is an excess of serotonin in the body, leading to symptoms such as confusion, hallucinations, rapid heart rate, increased body temperature, and more. Monitoring for serotonin syndrome is crucial when these substances are taken together to prevent any potential harm to the client.

5. Which of the following interventions is considered the most effective form of universal precautions?

• A. Cap all used needles before removing them from their syringes
• B. Discard all used uncapped needles and syringes in an impenetrable protective container
• C. Wear gloves when administering IM injections
• D. Follow enteric precautions

Correct answer: B

Rationale: The most effective form of universal precautions is to discard all used uncapped needles and syringes in an impenetrable protective container. This practice minimizes the risk of needle-stick injuries, which are a significant concern when dealing with used needles. By safely disposing of uncapped needles, healthcare providers can protect themselves and others from potential exposure to bloodborne pathogens.

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