Nursing Elites

1. A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?

• A. Once retinal detachment occurs, it does not return to its normal state
• B. Once the tissue has necrosed from high-pressure, it does not regenerate
• C. Glaucoma always leads to permanent blindness
• D. Once bacterial infection has caused damage, the tissue does not regenerate

Correct answer: B

Rationale: The correct explanation for irreversible vision loss in glaucoma is that once the tissue has necrosed from high pressure, it does not regenerate. This necrosis occurs due to the damage caused by increased intraocular pressure, which leads to irreversible damage to the optic nerve and retinal tissue. Choices A, C, and D are incorrect because they do not directly address the specific mechanism of irreversible vision loss in glaucoma, which is necrosis due to high pressure.

2. What intervention by the nurse would be the best to prevent deep vein thrombosis after a fracture of the hip?

• A. Encouraging bedrest
• B. Applying antiembolism stockings
• C. Tell the client to take anticoagulants
• D. Teaching about smoking cessation

Correct answer: B

Rationale: The best intervention to prevent deep vein thrombosis (DVT) after a fracture of the hip is to apply antiembolism stockings. These stockings help promote circulation and prevent blood clots from forming in the legs due to immobility. Encouraging bedrest is not recommended as it can increase the risk of DVT. While anticoagulants are used in some cases, the primary prevention method is mechanical prophylaxis like antiembolism stockings. Teaching about smoking cessation is important for overall health but is not directly related to preventing DVT in this scenario.

3. Most adults with human immunodeficiency virus will exhibit which of the following laboratory values?

• A. Higher than normal number of CD4+ T-cells and CD8+ T-cells are normal
• B. Lower than normal number of CD4+ T-cells and higher than normal CD8+ T-cells
• C. Higher than normal number of CD4+ T-cells and CD8+ T-cells are low
• D. Lower than normal number of CD4+ T-cells and CD8+ T-cells are normal

Correct answer: D

Rationale:

4. A client states that he has been experiencing oozing from his wounds. What is the nurse's priority action?

• A. Insert the wound and assess the drainage
• B. Apply topical ointment to the wound
• C. Call the provider to initiate antibiotics
• D. Culture the wound

Correct answer: D

Rationale:

5. A client arrives speaking only Spanish. What is the priority nursing intervention?

• A. Give the client a tour of the unit
• B. Verify the reason for admission
• C. Request a medical interpreter
• D. Call the chaplain for support

Correct answer: C

Rationale:

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