Nursing Elites

1. A client reports new onset hearing loss bilaterally after taking a medication with known ototoxic effects. Which type of hearing loss should the nurse suspect?

• A. Conductive
• B. Sensorineural
• C. Mixed
• D. Central

Correct answer: B

Rationale: The correct answer is B: Sensorineural. Ototoxic medications can lead to sensorineural hearing loss by affecting the inner ear or auditory nerve. Conductive hearing loss is related to issues in the middle or outer ear, not typically caused by ototoxic medications. Mixed hearing loss is a combination of conductive and sensorineural components. Central hearing loss is related to the central nervous system, not commonly caused by ototoxic medications. Therefore, in this case, the nurse should suspect sensorineural hearing loss.

2. The nurse is triaging clients who have been injured during a tornado. Which client requires immediate action?

• A. A young male with a minor laceration on his forearm.
• B. An elderly woman with a dislocated shoulder who is calm.
• C. A middle-aged female with a broken humerus who is unable to follow commands and is crying.
• D. A teenager with abrasions and a bruised knee.

Correct answer: C

Rationale: The middle-aged female with a broken humerus who is unable to follow commands and is crying requires immediate action. These symptoms indicate a possible head injury or severe emotional distress that need urgent attention. Choice A is not as urgent since a minor laceration can be addressed after more critical cases. Choice B, although having a dislocated shoulder, is stable, as the client is calm. Choice D presents with minor injuries that can wait while more critical cases are addressed.

3. A client with fluid volume excess has gained 6.6 pounds. The nurse recognizes that this is equivalent to what volume of fluid?

• A. Two liters.
• B. Three liters.
• C. Four liters.
• D. Five liters.

Correct answer: B

Rationale: A weight gain of 6.6 pounds is approximately equivalent to 3 liters of fluid. It is important to remember that 1 liter of fluid is equal to 1 kg, which is approximately 2.2 pounds. Therefore, when the client gains 6.6 pounds, it translates to 3 liters of fluid. Choices A, C, and D are incorrect as they do not align with the conversion rate of 1 liter of fluid to 2.2 pounds.

4. A client who has a history of unstable angina is admitted to the emergency department with chest pain.

• A. Chest pain relieved by rest.
• B. Chest pain unrelieved after taking 3 sequential nitroglycerin tablets.
• C. Chest pain occurring only with exertion.
• D. Chest pain lasting less than 5 minutes.

Correct answer: B

Rationale: Chest pain unrelieved after taking 3 sequential nitroglycerin tablets indicates a possible myocardial infarction and requires immediate medical attention.

5. When conducting a class for parents about sudden infant death syndrome (SIDS), the nurse instructs the class that the infant should be placed in which position to sleep?

• A. Right side-lying
• B. Left side-lying
• C. Prone
• D. Supine

Correct answer: D

Rationale: The correct answer is D, supine. The American Academy of Pediatrics recommends placing infants on their back, or supine, to sleep as it has been shown to reduce the risk of SIDS. Choices A, B, and C are incorrect because placing infants on their right side, left side, or prone (on their stomach) respectively are not recommended sleeping positions due to the increased risk of SIDS associated with those positions.

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