Nursing Elites

1. When teaching about preventable diseases, the importance of getting the following vaccines should be emphasized:

• A. human papillomavirus, genital herpes, measles.
• B. pneumonia, HIV, mumps.
• C. syphilis, gonorrhea, pneumonia.
• D. polio, pertussis, measles

Correct answer: D

Rationale: Vaccines are crucial in preventing communicable diseases. Smallpox has been eradicated globally, so its vaccine is no longer used. Polio, pertussis, and measles are diseases that are controlled by routine childhood immunization. While smallpox has been eradicated, these diseases still exist, making it essential for children to be vaccinated against them. Choices A, B, and C include diseases that are not prevented by vaccination or are not related to routine immunizations, making them incorrect choices.

2. Which dietary consideration is most important for the nurse to teach to a client with hypothyroidism?

• A. Increase carbohydrate intake
• B. Increase fluid intake
• C. Avoid shellfish
• D. Increase fiber

Correct answer: D

Rationale: The correct answer is to 'Increase fiber.' In hypothyroidism, clients often experience constipation due to decreased metabolic rate. Increasing fiber in the diet can help alleviate constipation. Choice A, 'Increase carbohydrate intake,' is incorrect as there is no specific need to increase carbohydrate intake in hypothyroidism. Choice B, 'Increase fluid intake,' is not directly related to managing hypothyroidism, although adequate hydration is generally important for overall health. Choice C, 'Avoid shellfish,' is commonly associated with hyperthyroidism due to its iodine content, not hypothyroidism.

3. A child with newly diagnosed leukemia is receiving chemotherapy. Which would be included in his plan of care by the nurse?

• A. Place the child in a negative pressure isolation room
• B. Administer prophylactic IV antibiotics
• C. Avoid high protein food intake
• D. Teach family and visitors handwashing techniques

Correct answer: D

Rationale: The correct answer is to teach family and visitors handwashing techniques. Any client on chemotherapy should have good infection control measures in place, such as handwashing by all who they encounter. Placing the child in a negative pressure isolation room (Choice A) is not necessary unless specifically indicated for a certain condition. Administering prophylactic IV antibiotics (Choice B) may not be part of the standard care plan for a child with leukemia receiving chemotherapy. Avoiding high protein food intake (Choice C) is not directly related to infection control and may not be necessary unless there are specific dietary restrictions.

4. During a home health visit, a nurse consults with a male patient diagnosed with CAD and COPD who is taking Ventolin, Azmacort, Aspirin, and Theophylline and complains of upset stomach, nausea, and discomfort. What should the nurse do?

• A. Contact the patient's physician immediately
• B. Recommend the patient lie on his right side
• C. Advise the patient to schedule a doctor's visit the next day
• D. Suggest holding the drug Azmacort

Correct answer: A

Rationale: The correct answer is to contact the patient's physician immediately. The patient's symptoms of upset stomach, nausea, and discomfort could indicate theophylline toxicity, a potentially serious condition. It is crucial to consult the physician promptly to address this issue. Option B, recommending the patient lie on his right side, is incorrect as it does not address the potential theophylline toxicity and is not a priority. Option C, advising the patient to schedule a doctor's visit the next day, is inappropriate as the symptoms may indicate an urgent concern. Option D, suggesting holding the drug Azmacort, is incorrect as it does not address the potential theophylline toxicity and should not be done without consulting the physician first.

5. When administering intravenous electrolyte solution, what precaution should the nurse take?

• A. Infuse hypertonic solutions cautiously.
• B. Mix no more than 60 mEq of potassium per liter of fluid.
• C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
• D. Monitor the client's digitalis dosage for adjustments due to IV calcium.

Correct answer: C

Rationale: When administering intravenous electrolyte solutions, preventing the infiltration of calcium is crucial to avoid tissue necrosis and sloughing, making choice C the correct answer. Choice A is revised to 'Infuse hypertonic solutions cautiously' because hypertonic solutions should be infused cautiously to prevent adverse effects. Choice B is corrected to 'Mix no more than 60 mEq of potassium per liter of fluid' as exceeding this limit can lead to hyperkalemia. Choice D is modified to 'Monitor the client's digitalis dosage for adjustments due to IV calcium' as it is essential to monitor the digitalis dosage for potential adjustments when IV calcium is administered; however, this choice is incorrect here as it inaccurately suggests adjusting the digitalis dosage due to IV calcium, which could lead to harmful effects.

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