Nursing Elites

1. A client with a history of seizures is receiving phenytoin (Dilantin). The nurse should monitor the client for which of the following side effects?

• A. Hypertension
• B. Hyperglycemia
• C. Gingival hyperplasia
• D. Hypokalemia

Correct answer: C

Rationale: The correct answer is C: Gingival hyperplasia. Phenytoin can cause gingival hyperplasia, characterized by an overgrowth of gum tissue. It is important for the nurse to monitor the client for this side effect as it can lead to oral health issues. Choices A, B, and D are incorrect. Phenytoin does not typically cause hypertension, hyperglycemia, or hypokalemia as common side effects.

2. During a home visit for a family with a new baby, what should the nurse assess first?

• A. feeding patterns
• B. sleeping arrangements
• C. support system
• D. immunization status

Correct answer: A

Rationale: Assessing feeding patterns is the priority during a home visit for a family with a new baby because it is crucial for the health and growth of the newborn. By evaluating the feeding patterns, the nurse can ensure that the baby is receiving adequate nutrition and address any feeding issues promptly. While sleeping arrangements, support system, and immunization status are important aspects to assess during a home visit, they are not as critical as ensuring the newborn's nutritional needs are being met.

3. The nurse is teaching childbirth preparation classes. One woman asks about her rights to develop a birthing plan. Which response made by the nurse would be best?

• A. "What is your reason for wanting such a plan?"
• B. "Have you talked with your health care provider about this?"
• C. "Let us discuss your rights as a couple."
• D. "Write your ideal plan for the next class."

Correct answer: C

Rationale: Discussing the rights as a couple allows for open communication and helps ensure that the birthing plan aligns with the couple's preferences and medical advice.

4. Occupational health nursing is concerned with the following except:

• A. educating workers about health
• B. immediate diagnosis of illness prevailing in the work field
• C. appropriate and effective ways of promoting health
• D. planning of administering health services

Correct answer: B

Rationale: Occupational health nursing focuses on educating workers about health, promoting health through appropriate and effective ways, and planning and administering health services in the workplace. Immediate diagnosis of illness prevailing in the work field is typically not the primary role of occupational health nursing, as it usually involves prevention, education, and health promotion rather than diagnosing acute conditions.

5. Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?

• A. Encourage the employees to disclose if they have joined another smoking cessation group.
• B. Ask the employees to inform the group if they stop smoking and if they start back up again.
• C. Survey the employees about their smoking habits.
• D. Observe if the employees are smoking in the designated smoking areas.

Correct answer: C

Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.

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