Nursing Elites

1. A 44-year-old man presents with muscle weakness and fatigue. He states that he has experienced difficulty climbing stairs and even holding his arms up to comb his hair. Which test is most likely to help confirm the diagnosis?

• A. Electromyography (EMG)
• B. Nerve conduction studies
• C. Muscle biopsy
• D. Blood test for autoantibodies

Correct answer: A

Rationale: The correct answer is Electromyography (EMG). EMG is commonly used to diagnose conditions involving muscle weakness and fatigue, such as myasthenia gravis. Nerve conduction studies primarily assess nerve function rather than muscle involvement. While a muscle biopsy can provide valuable information, EMG is more specific for evaluating muscle function in this context. A blood test for autoantibodies may be helpful in certain autoimmune conditions but is not the primary test for confirming the diagnosis based on the patient's symptoms of muscle weakness and fatigue.

2. A client with cystic fibrosis is admitted with a pulmonary exacerbation. Which intervention should the nurse prioritize?

• A. Administer a high-calorie, high-protein diet.
• B. Initiate airway clearance techniques.
• C. Encourage the client to maintain an active lifestyle.
• D. Monitor for signs of respiratory distress.

Correct answer: B

Rationale: During a pulmonary exacerbation in cystic fibrosis, the priority intervention is to initiate airway clearance techniques. These techniques help clear mucus from the airways, improving ventilation and reducing the risk of respiratory complications. Administering a high-calorie, high-protein diet is beneficial for overall nutrition but is not the priority during an exacerbation. Encouraging an active lifestyle is important for long-term health but does not address the immediate need for managing exacerbations. Monitoring for signs of respiratory distress is important, but initiating airway clearance techniques takes precedence in the management of pulmonary exacerbations in cystic fibrosis.

3. What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?

• A. Active immunity
• B. Passive immunity
• C. Innate immunity
• D. Natural immunity

Correct answer: A

Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.

4. Which of the following are signs and symptoms of myocardial infarction?

• A. Persistent chest pain which may radiate to the arm
• B. Brief sternal chest pain on inspiration
• C. Rapid respirations with left-sided weakness and numbness
• D. Left upper quadrant abdominal pain which radiates to the back and shoulder

Correct answer: A

Rationale: The correct answer is A. Persistent chest pain that may radiate to the arm is a classic symptom of myocardial infarction. This pain is typically described as crushing, pressure-like, or squeezing. Choice B is incorrect because brief sternal chest pain on inspiration is not characteristic of myocardial infarction. Choice C is incorrect because rapid respirations with left-sided weakness and numbness are not typical symptoms of myocardial infarction. Choice D is incorrect because left upper quadrant abdominal pain that radiates to the back and shoulder is not a common presentation of myocardial infarction.

5. A homeless man was screened for tuberculosis (TB) during a health consultation at a shelter, and the results indicate latent TB. The community health nurse who is liaising with the providers of the shelter would anticipate what component of this man's plan of care?

• A. The man will undergo conservative treatment for TB using adjuvant medications.
• B. The man will be treated for TB using first-line antitubercular drugs.
• C. The man will be monitored closely to determine if treatment is necessary.
• D. The man will be screened again in 10 to 12 weeks to determine if he has developed active TB.

Correct answer: B

Rationale: The correct answer is B. When a patient is diagnosed with latent TB infection, the standard approach involves treating them with first-line antitubercular drugs to prevent the progression to active TB. Adjuvant medications are not typically used for latent TB. Close monitoring without initiating treatment can lead to the development of active TB, so immediate treatment is crucial. Screening the individual again in 10 to 12 weeks does not address the immediate need for treatment of latent TB, which is essential to prevent the progression of the disease.

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