Nursing Elites

1. A home care nurse visits a patient who is bed-bound and lives in a 12-story high-rise apartment complex. Her daughter states that she has small red skin lesions over her body and she has been itching. What parasite is most likely responsible for this patient's skin lesions?

• A. Sarcoptes scabiei
• B. Pediculus humanus corporis
• C. Pediculus humanus pubis
• D. Toxoplasma gondii

Correct answer: A

Rationale: The correct answer is Sarcoptes scabiei. Sarcoptes scabiei is a parasitic mite that causes scabies, characterized by small red skin lesions and intense itching. Pediculosis corporis (choice B) refers to body lice, which do not cause the specific symptoms described. Pediculosis pubis (choice C) is caused by pubic lice and presents differently from the symptoms described. Toxoplasma gondii (choice D) is a parasite that causes toxoplasmosis, but it does not typically manifest with small red skin lesions and itching.

2. After ingestion of cysts, how long does it take for the symptoms of giardiasis to develop?

• A. 12 to 24 hours
• B. 3 to 5 days
• C. 1 to 2 weeks
• D. 2 to 3 months

Correct answer: B

Rationale: Giardiasis symptoms typically develop 3 to 5 days after ingestion of the cysts. This timeframe aligns with the incubation period of the Giardia parasite. Choice A (12 to 24 hours) is too short for giardiasis to manifest. Choice C (1 to 2 weeks) and choice D (2 to 3 months) represent durations that are not consistent with the usual onset of symptoms in giardiasis.

3. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

4. During admission, 82-year-old Mr. Robeson is brought to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client’s daughter best supports the diagnosis?

• A. “Maybe it’s just caused by aging. This usually happens by age 82.”
• B. “The changes in his behavior came on so quickly! I wasn’t sure what was happening.”
• C. “Dad just didn’t seem to know what he was doing. He would forget what he had for breakfast.”
• D. “Dad has always been so independent. He’s lived alone for years since mom died.”

Correct answer: B

Rationale: The correct answer is B because sudden onset of behavioral changes is a typical symptom of delirium. Delirium is characterized by an acute and fluctuating disturbance in attention, awareness, and cognition. Choice A is incorrect because delirium is not a normal part of aging. Choice C describes memory issues, which can be seen in delirium but are less specific than sudden behavioral changes. Choice D, while it mentions the patient's independence, does not directly support the diagnosis of delirium.

5. Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?

• A. Crossed-extensor reflex
• B. Flexor reflex
• C. Withdrawal reflex
• D. Stretch reflex

Correct answer: C

Rationale: The withdrawal reflex is a protective response that allows a person to quickly remove their hand from a painful stimulus.

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