Nursing Elites

1. A nurse assisting with data collection notes that the client exhibits rapid, involuntary oscillating movements of the eyeball when looking at the nurse. The nurse documents this finding using which term?

• A. Ptosis
• B. Nystagmus
• C. Scleral icterus
• D. Exophthalmos

Correct answer: B

Rationale: When a nurse observes rapid, involuntary oscillating movements of the eyeball in a client, this is described as nystagmus. Nystagmus appears as a fine oscillating movement, most notable around the iris. It is important to assess for nystagmus when evaluating ocular muscle weakness. Mild nystagmus at extreme lateral gaze is considered normal; nystagmus in any other position is not. Ptosis refers to a drooping of the eyelid, not rapid eye movements. Scleral icterus is the yellowing of the sclera up to the cornea, indicating jaundice, not related to eye movements. Exophthalmos is a noticeable protrusion of the eyeball, typically seen in hyperthyroidism, not associated with rapid oscillating eye movements.

2. What ethical obligations do professional nurses have according to the ANA Code of Ethics for Nurses?

• A. patients.
• B. the nursing profession.
• C. provide high-quality care.
• D. all of the above

Correct answer: D

Rationale: The correct answer is 'all of the above.' According to the ANA Code of Ethics for Nurses, professional nurses have ethical obligations to patients (clients), the nursing profession, and providing high-quality care. These elements are fundamental principles outlined in the code of ethics to guide nurses in their practice. Choice A is correct as nurses prioritize the well-being and care of their patients. Choice B is correct as nurses are expected to uphold the values and integrity of the nursing profession. Choice C is correct as providing high-quality care is a core ethical obligation of nurses. Therefore, all the choices align with the ANA Code of Ethics for Nurses.

3. When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?

• A. family history of stroke
• B. ovaries removed before age 45
• C. frequent hot flashes and/or night sweats
• D. unexplained vaginal bleeding

Correct answer: D

Rationale: When considering hormone replacement therapy for a menopausal woman, unexplained vaginal bleeding should be recognized as a contraindication. This is because it could be indicative of a serious underlying condition that needs investigation before initiating hormone therapy. A family history of stroke, by itself, is not a contraindication for hormone replacement therapy, unless the woman herself has a history of stroke or blood-clotting events. Ovaries removed before age 45 may actually increase the likelihood of needing hormone replacement therapy due to early menopause. Frequent hot flashes and night sweats, on the other hand, are symptoms that can be relieved by hormone replacement therapy, making them a potential indication rather than a contraindication.

4. A mother has come to the pediatric clinic concerned about the recent outbreak of West Nile Virus. The ages of her children are 5, 7, and 10. The mother has asked the nurse what she can do to prevent her children from contracting this illness. Which piece of information is best to provide the mother with?

• A. The children should wear long sleeves and long pants while outside.
• B. Apply insect repellent containing DEET when the children are outside.
• C. Remove standing water from the property.
• D. All of the above.

Correct answer: D

Rationale: The best advice to provide to the mother is 'All of the above.' It is recommended that the children wear insect repellent containing DEET and long-sleeved shirts and long pants when they are outside. This helps in preventing mosquito bites, which can transmit the West Nile Virus. Additionally, removing standing water from areas where the children play can help decrease the number of breeding mosquitoes, reducing the risk of contracting the virus. These methods work in combination to provide effective prevention against the West Nile Virus, making 'All of the above' the correct choice. Choices A, B, and C individually address important prevention measures, but a combination of all three strategies is the most comprehensive approach to protect the children from contracting the illness.

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

• A. it focuses on the health beliefs of a particular family.
• B. it highlights the impact of culture on health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is based on an educational approach.

Correct answer: C

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the influence of popular and folk domains on health perceptions. Kleinman distinguishes between disease, representing the biomedical view, and illness, reflecting individual understanding. The model underscores that cultural factors shape the significance of popular and folk influences on health beliefs. Choice A is incorrect as the model focuses on broader cultural influences, not individual family beliefs. Choice B is incorrect as it oversimplifies the model's emphasis on various cultural aspects. Choice D is incorrect as the model's significance lies in its cultural framework rather than an educational base.

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