Nursing Elites

1. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.

2. An example of individual influences on health status would be:

• A. Cigarette smoking
• B. A parent with adult-onset diabetes
• C. Exposure to toxic substances in the workplace
• D. All of the above

Correct answer: D

Rationale: The correct answer is 'D' because all the listed factors - cigarette smoking, a parent with adult-onset diabetes, and exposure to toxic substances in the workplace - can individually influence a person's health status. Cigarette smoking directly impacts health by increasing the risk of various diseases. Having a parent with adult-onset diabetes can also influence one's health due to genetic predisposition and lifestyle factors. Exposure to toxic substances in the workplace can lead to health issues. Choices A, B, and C are not mutually exclusive but rather represent different aspects of individual influences on health status, making 'D' the most comprehensive and accurate answer.

3. A nurse working in the community assumes different roles. When the nurse acts as a community organizer, they perform which of the following functions?

• A. motivate and enhance community participation when planning and implementing health programs and services
• B. develop the family's capability to take care of a sick member
• C. identify needs, priorities, and problems of individuals, families, and the community
• D. participate in community development activities

Correct answer: D

Rationale: When a nurse acts as a community organizer, they participate in community development activities, which involve working with the community to address issues such as healthcare access, social services, and infrastructure. The other choices do not directly align with the role of a community organizer. Choice A is more related to community participation in health programs, choice B focuses on family care, and choice C pertains to identifying needs and priorities rather than organizing community development activities.

4. A 16-year-old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer?

• A. MMR
• B. Hepatitis B
• C. Human papillomavirus
• D. Pneumococcal

Correct answer: B

Rationale: The correct answer is B, Hepatitis B. The Hepatitis B vaccine is crucial for pregnant women to prevent transmission of the virus to the baby during childbirth. Option A, MMR (Measles, Mumps, Rubella) vaccine, is not indicated during pregnancy. Option C, Human papillomavirus vaccine, is recommended for prevention of HPV infections but is not specifically indicated during pregnancy. Option D, Pneumococcal vaccine, is important for certain populations but is not the priority vaccine for a pregnant woman in this scenario.

5. The nurse is teaching a client about the healthy use of ego defense mechanisms. An appropriate goal for this client would be

• A. Reduce fear and protect self-esteem
• B. Minimize anxiety and delay apprehension
• C. Avoid conflict and leave unpleasant situations
• D. Increase independence and communicate more effectively

Correct answer: A

Rationale: The correct answer is A: 'Reduce fear and protect self-esteem.' When teaching a client about the healthy use of ego defense mechanisms, the goal is to help the individual manage emotions effectively without denying reality. Using defense mechanisms in a healthy way aims to reduce fear and protect self-esteem while still addressing underlying issues. Choices B, C, and D are incorrect because they do not focus on the core principles of using defense mechanisms in a healthy manner. Minimizing anxiety and delaying apprehension, avoiding conflict and leaving unpleasant situations, and increasing independence and communicating more effectively do not directly align with the goal of utilizing ego defense mechanisms in a constructive way.

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