Nursing Elites

1. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

2. Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

3. A community that uses the resources of a neighborhood church to provide a latchkey children program, to sponsor prayer/support groups for people who are ill, and to grow a community health garden that sends vegetables to elderly shut-ins is engaged in what kind of activity?

• A. disease prevention
• B. health protection
• C. risk management
• D. health balance

Correct answer: B

Rationale: In this scenario, the community activities described focus on supporting and promoting overall well-being, which aligns with the concept of health protection. Choice A, disease prevention, is incorrect as the activities are more about supporting health rather than preventing specific diseases. Choice C, risk management, does not fit as the activities are not primarily about managing risks. Choice D, health balance, is not the most appropriate choice as the activities are aimed at protecting and enhancing health rather than achieving a balance.

4. When caring for premature newborns in an intensive care setting, a nurse carefully monitors oxygen concentration. What is the most common complication of this therapy?

• A. Intraventricular hemorrhage
• B. Retinopathy of prematurity
• C. Bronchopulmonary dysplasia
• D. Necrotizing enterocolitis

Correct answer: B

Rationale: Retinopathy of prematurity is the most common complication in premature infants exposed to high concentrations of oxygen. This condition leads to abnormal blood vessel growth in the retina, which can potentially result in blindness if not managed promptly. Intraventricular hemorrhage, though a significant concern in premature infants, is not directly related to oxygen therapy. Bronchopulmonary dysplasia is primarily associated with mechanical ventilation and oxygen exposure over time, not specifically with oxygen concentration monitoring. Necrotizing enterocolitis is more linked to gastrointestinal issues and is not the most common complication of oxygen therapy in premature newborns.

5. In addition to disturbances in mental awareness and orientation, a client with cognitive impairment is also likely to show loss of ability in

• A. Hearing, speech, and sight
• B. Endurance, strength, and mobility
• C. Learning, creativity, and judgment
• D. Balance, flexibility, and coordination

Correct answer: C

Rationale: Individuals with cognitive impairment often experience difficulties in learning new information, creative thinking, and making sound judgments. Loss of ability in hearing, speech, and sight (Choice A) is more closely related to sensory impairments rather than cognitive impairment. Endurance, strength, and mobility (Choice B) are more associated with physical capabilities rather than cognitive functions. Balance, flexibility, and coordination (Choice D) are related to motor skills and physical coordination, not cognitive impairment.

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