Nursing Elites

1. Which sexually transmitted disease, sometimes referred to as the silent STD, is more common than gonorrhea and a leading cause of PID?

• A. Genital herpes.
• B. Trichomoniasis.
• C. Syphilis.
• D. Chlamydia.

Correct answer: D

Rationale: The correct answer is Chlamydia. Chlamydia is a common sexually transmitted infection that can often be asymptomatic, earning it the nickname 'silent STD.' It is more common than gonorrhea and is a leading cause of Pelvic Inflammatory Disease (PID). Genital herpes (Choice A) is a viral infection, not a bacterial STD like chlamydia. Trichomoniasis (Choice B) is a parasitic infection and not commonly associated with causing PID. Syphilis (Choice C) is a bacterial infection but is not as common as chlamydia and is not a leading cause of PID.

2. The client is admitted to the hospital following a motor vehicle accident and has sustained a closed chest wound. Which assessment finding is consistent with a flail chest?

• A. Biot's respirations
• B. Sucking sounds during respirations
• C. Paradoxical chest wall movement
• D. Hypotension and bradycardia

Correct answer: C

Rationale: The correct assessment finding consistent with a flail chest is paradoxical chest wall movement. This occurs when a segment of the chest wall moves in the opposite direction to the rest of the chest during respiration. Biot's respirations (Choice A) are a pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea. Sucking sounds during respirations (Choice B) may indicate air entering or leaving the chest cavity through a wound. Hypotension and bradycardia (Choice D) may be present due to other factors such as shock, but they are not specific to a flail chest.

3. A 55-year-old female asks a nurse the following, “Which mineral/vitamin is the most important to prevent the progression of osteoporosis?” The nurse should state:

• A. Potassium
• B. Magnesium
• C. Calcium
• D. Vitamin B12

Correct answer: C

Rationale: The correct answer is C: Calcium. Calcium is essential for maintaining bone health and is crucial in preventing osteoporosis. Adequate calcium intake, along with vitamin D, is vital for bone strength. While other minerals and vitamins are also important for overall health, in the context of preventing osteoporosis, calcium plays a primary role. Potassium (Choice A), Magnesium (Choice B), and Vitamin B12 (Choice D) are important for various bodily functions but are not as directly linked to preventing osteoporosis as calcium.

4. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?

• A. "This diet can be used when there is close medical supervision."?
• B. "This is a long-term treatment measure that assists obese people who can't lose weight."?
• C. "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."?
• D. "A VLCD contains very little protein."?

Correct answer: A

Rationale: The correct answer is, "This diet can be used when there is close medical supervision."? Very low-calorie diets (VLCDs) are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis. Choice B is incorrect because VLCDs are typically short-term interventions. Choice C is incorrect because VLCDs usually consist of nutritionally complete liquid formulations, not solid food items that are pureed. Choice D is incorrect because VLCDs actually contain a high quality of protein, although the overall caloric content is very low.

5. The nurse observes a nursing assistant performing AM care for a client with a new leg cast. Which action by the assistant will the nurse intervene?

• A. Lifting the affected leg with the palms of the hands
• B. Covering the affected leg with a blanket to avoid chills
• C. Placing plastic over the groin prior to bathing
• D. Elevating the casted leg on two pillows

Correct answer: B

Rationale: The correct answer is to intervene when the assistant covers the affected leg with a blanket to avoid chills. A new cast should not be covered to allow the heat from the cast to evaporate, preventing complications. Lifting the affected leg with the palms of the hands is appropriate for proper handling. Placing plastic over the groin prior to bathing is a standard practice to protect the client's privacy and maintain hygiene. Elevating the casted leg on two pillows helps reduce swelling and promote circulation, making it a suitable action.

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