Nursing Elites

1. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?

• A. Use a visual analog scale (VAS) to assess the pain.
• B. Ask the child to rate their pain on a scale of 0 to 10.
• C. Use the Wong-Baker FACES scale to assess the pain.
• D. Ask the parents to describe the child's pain behavior.

Correct answer: C

Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.

2. A 51-year-old woman has the following clinical findings: thin hair, exophthalmos, hyperreflexia, and pretibial edema. These findings are consistent with:

• A. Subacute thyroiditis.
• B. Autoimmune thyroiditis.
• C. Graves disease.
• D. Hashimoto’s disease.

Correct answer: C

Rationale: The clinical findings of thin hair, exophthalmos, hyperreflexia, and pretibial edema are classic features of Graves disease, an autoimmune disorder that results in hyperthyroidism. Exophthalmos (bulging eyes) and pretibial edema (swelling in the lower legs) are particularly associated with Graves disease due to the autoimmune stimulation of the thyroid gland, leading to increased thyroid hormone production. Subacute thyroiditis (Choice A) typically presents with neck pain and tenderness, while autoimmune thyroiditis (Choice B) is commonly known as Hashimoto's thyroiditis, which presents with hypothyroidism symptoms. Hashimoto's disease (Choice D) is characterized by goiter and hypothyroidism, which contrasts with the hyperthyroidism seen in this patient.

3. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:

• A. psychotherapy.
• B. total abstinence.
• C. Alcoholics Anonymous (AA).
• D. aversion therapy.

Correct answer: B

Rationale: The correct answer is B: total abstinence. Total abstinence from alcohol is considered the most effective treatment for alcoholism. This approach eliminates the risk of relapse and helps individuals maintain sobriety. While psychotherapy can be beneficial in addressing underlying issues, total abstinence is crucial in overcoming alcohol addiction. Alcoholics Anonymous (AA) is a supportive group that can complement treatment, but it is not the only effective approach. Aversion therapy aims to create a negative association with alcohol but may not address the underlying causes of addiction, making total abstinence a more comprehensive and recommended approach.

4. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

5. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

• A. Human immunodeficiency virus
• B. Drug-resistant tuberculosis
• C. Methicillin-resistant Staphylococcus aureus
• D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

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