Nursing Elites

1. A client with peripheral artery disease tells the nurse that pain develops in his left calf when he is walking and subsides with rest. The nurse documents that the client is most likely experiencing which disorder?

• A. Venous insufficiency
• B. Intermittent claudication
• C. Sore muscles from overexertion
• D. Muscle cramps related to musculoskeletal problems

Correct answer: B

Rationale: Leg pain characteristic of peripheral artery disease is known as intermittent claudication. The client can walk only a certain distance before cramping, burning, muscle discomfort, or pain forces them to stop, with the pain subsiding after rest. The pain is reproducible, and as the disease progresses, the client can walk shorter distances before the pain recurs. Ultimately, pain may even occur at rest. Venous insufficiency (Choice A) involves impaired blood flow in the veins, leading to swelling and skin changes but not typically pain associated with exercise. Sore muscles from overexertion (Choice C) and muscle cramps related to musculoskeletal problems (Choice D) do not present with the characteristic pattern of pain associated with peripheral artery disease.

2. A female client asks a nurse about the advantages of using a female condom. The nurse discusses which advantage with the client?

• A. That it offers protection against sexually transmitted infections (STIs)
• B. That it cannot be used along with a male condom
• C. That it does not have to be discarded after use and can be used several times before a new one must be obtained
• D. That it is 100% effective in preventing pregnancy

Correct answer: A

Rationale: The correct answer is that the female condom offers protection against sexually transmitted infections (STIs). Unlike the male condom, the female condom is a loose-fitting tubular polyurethane pouch that is anchored over the labia and cervix. It is used once and then discarded, making choice C incorrect. Female and male condoms should not be used together, so choice B is incorrect. Additionally, no contraceptive method is 100% effective in preventing pregnancy, making choice D incorrect.

3. When planning for the physical assessment of the woman, the nurse ensures that which occurs?

• A. The woman is examined by a female health care provider.
• B. The woman's husband remains in the examining room at all times.
• C. The woman is examined without any other people in the examining room.
• D. Written permission is obtained from the woman to obtain subjective health data.

Correct answer: A

Rationale: In many cultures, including Muslim, Hindu, and Latino, modesty is important, and exposure of a woman's genitals to men is considered demeaning. To respect the patient's cultural beliefs and modesty, it is best for a female health care provider to perform the examination. This practice helps to ensure the patient's comfort and adherence to cultural norms. Having the woman examined without any other people in the room (Choice C) may not address the cultural sensitivity required for this situation. Having the woman's husband remain in the examining room at all times (Choice B) may not align with the patient's cultural preferences and may cause discomfort. Written permission from the woman to obtain subjective health data (Choice D) is not directly related to ensuring a culturally sensitive physical assessment in this context.

4. When determining a fetal heart rate (FHR) and noting accelerations from the baseline rate when the fetus is moving, a nurse interprets this finding as:

• A. A reassuring sign
• B. An indication of the need to contact the physician
• C. An indication of fetal distress
• D. A nonreassuring sign

Correct answer: A

Rationale: When a nurse notes accelerations from the baseline rate of the fetal heart rate, particularly when they occur with fetal movement, it is considered a reassuring sign. This indicates a healthy response to fetal activity. Reassuring signs in FHR monitoring include an average rate between 120 and 160 beats/min at term, a regular rhythm with slight fluctuations, accelerations from the baseline rate (often associated with fetal movement), and the absence of decreases from the baseline rate. Choices B, C, and D are incorrect because accelerations in FHR with fetal movement are not indicative of the need to contact the physician, fetal distress, or a nonreassuring sign. These signs would typically be associated with other abnormal FHR patterns that would warrant further assessment and intervention.

5. Why is Kleinman's Explanatory Model of Health and Illness significant?

• A. it explains the health beliefs a family is likely to have.
• B. it emphasizes the role of culture in shaping health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is structured based on education.

Correct answer: B

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the crucial role that popular and folk domains of influence play in shaping individuals' understanding of health and illness. Kleinman distinguishes between disease, which is the biomedical understanding of health problems, and illness, which is the individual's personal interpretation of their health condition. By focusing on the cultural factors that influence these domains of influence, Kleinman's model underscores the impact of cultural beliefs and practices on health perceptions. Choice A is incorrect because the model goes beyond just family health beliefs. Choice B is more precise as it emphasizes the broader influence of culture. Choice C highlights the correct significance of popular and folk domains of influence, making it the correct choice. Choice D is incorrect as the model's significance lies in cultural domains, not educational structure.

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