Nursing Elites

1. Which of the following statements is true about syphilis?

• A. The cause and mode of transmission are well understood.
• B. There is no known cure for the disease.
• C. When the primary lesion heals, the disease is cured.
• D. Syphilis can be cured with a course of antibiotic therapy.

Correct answer: D

Rationale: The correct statement about syphilis is that it can be cured with a course of antibiotic therapy. Syphilis is a treponemal disease that can be effectively treated with antibiotics, particularly long-acting penicillin G. The primary lesion of syphilis, known as a chancre, typically appears about three weeks after exposure and can involute even without specific treatment. If left untreated, secondary manifestations may occur, followed by latent periods. Specific treatment with antibiotics is crucial to prevent progression and transmission of the disease. Therefore, option D is correct. Option A is incorrect because the cause and mode of transmission of syphilis are well understood. Option B is incorrect as there is a known cure for syphilis. Option C is incorrect because the healing of the primary lesion does not indicate a cure for the disease.

2. The LPN is caring for a client with an NG tube, and the RN administers evening medications through the NG tube. The client asks if he can lie down when the nurse leaves the room. What is the most appropriate response?

• A. You can lie down in 1 hour.
• B. You can lie down in 30 minutes if your NG residual is below 50 mL.
• C. You can lie down in about 30 minutes.
• D. Yes, feel free to lie down.

Correct answer: A

Rationale: After administering medication through an NG tube, the client should remain upright for 30 minutes to ensure proper absorption of the medications. Therefore, the most appropriate response is to advise the client to lie down in 1 hour. Choice B is incorrect because waiting only 30 minutes may not provide sufficient time for the medications to be fully absorbed, as the recommended time is 30 minutes. Choice C is misleading as it incorrectly suggests that lying down in about 30 minutes is acceptable, which could compromise medication effectiveness. Choice D is incorrect as it does not provide accurate information regarding the appropriate timing for lying down after NG tube medication administration, potentially leading to decreased medication absorption.

3. A client who has undergone a total hip replacement is told that she will need to go to an extended care rehabilitation facility for therapy before going home. Which member of the healthcare team should the nurse ask to plan the discharge and transition from the hospital to the rehabilitation facility?

• A. Physical therapist
• B. Occupational therapist
• C. Clergy
• D. Social worker

Correct answer: D

Rationale: In this scenario, the appropriate member of the healthcare team to plan the discharge and transition from the hospital to the rehabilitation facility is the social worker. Social workers are trained to provide counseling services, emotional support, arrange placements in care facilities, and locate financial resources for clients. While clergy provide spiritual support and guidance, physical therapists assist in physical treatments, and occupational therapists help with activities of daily living, the social worker is best suited to address the client's needs related to discharge planning and transition. Therefore, the correct answer is the social worker.

4. A safety measure to implement when transferring a client with hemiparesis from a bed to a wheelchair is:

• A. standing the client and walking him or her to the wheelchair.
• B. moving the wheelchair close to the client's bed and standing and pivoting the client on his unaffected extremity to the wheelchair.
• C. moving the wheelchair close to the client's bed and standing and pivoting the client on his affected extremity to the wheelchair.
• D. having the client stand and push his body to the wheelchair.

Correct answer: B

Rationale: When transferring a client with hemiparesis from a bed to a wheelchair, it is crucial to ensure their safety. The correct safety measure involves moving the wheelchair close to the client's bed and having the client stand and pivot on his unaffected extremity to the wheelchair. This method provides support with the unaffected limb, reducing the risk of falls and promoting a safer transfer. Choice A is incorrect because walking the client is unsafe and not recommended. Choice C is incorrect as pivoting the client on his affected extremity can lead to injury or falls due to weakness or lack of control. Choice D is incorrect as it puts the client at risk by requiring them to push their body, which may not be feasible or safe for someone with hemiparesis.

5. A client with which of the following conditions is at risk for developing a high ammonia level?

• A. renal failure
• B. psoriasis
• C. lupus
• D. cirrhosis

Correct answer: D

Rationale: A client with cirrhosis is at risk for developing a high ammonia level due to impaired liver function. The liver normally converts ammonia into urea for excretion. In cirrhosis, this process is compromised, leading to elevated ammonia levels in the blood. Renal failure, psoriasis, and lupus do not typically cause high ammonia levels. Renal failure affects kidney function, while psoriasis and lupus are autoimmune conditions that do not directly impact ammonia metabolism.

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