Nursing Elites

1. A nurse in an emergency department is serving on a committee that is reviewing the facility protocol for disaster readiness. The nurse should recommend that the protocol include which of the following as a clinical manifestation of smallpox?

• A. Bloody diarrhea
• B. Ptosis of the eyelids
• C. Descending paralysis
• D. Rash in the mouth

Correct answer: D

Rationale: The correct answer is D, 'Rash in the mouth.' Smallpox presents with a distinctive rash that typically begins in the mouth and spreads to the rest of the body, developing into pustules. This rash is a key clinical manifestation of smallpox. This infectious disease is characterized by the rash, fever, and other systemic symptoms. Choices A, B, and C are incorrect because they are not associated with smallpox. Bloody diarrhea, ptosis of the eyelids, and descending paralysis are not typical clinical manifestations of smallpox.

2. A child is prescribed ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take with meals
• B. Take at bedtime
• C. Take with a glass of milk
• D. Take with a glass of orange juice

Correct answer: D

Rationale: The correct answer is to take ferrous sulfate with a glass of orange juice. Vitamin C, found in orange juice, enhances iron absorption. Taking iron with milk (choice C) is not recommended as it reduces iron absorption. Taking it with meals (choice A) can hinder its absorption due to other food components. Taking it at bedtime (choice B) doesn't affect absorption but might cause gastrointestinal upset in some individuals.

3. A nurse is caring for a toddler diagnosed with respiratory syncytial virus (RSV). Which of the following actions should the nurse take?

• A. Use a designated stethoscope when caring for the toddler
• B. Wear an N95 respirator mask
• C. Remove the disposable gown after leaving the toddler’s room
• D. Place the toddler in a room with negative air pressure

Correct answer: A

Rationale: Using a designated stethoscope is the correct action when caring for a toddler diagnosed with RSV. This measure helps prevent the spread of infection to other clients by reducing the risk of contamination. Wearing an N95 respirator mask is not necessary for routine care of a toddler with RSV unless performing aerosol-generating procedures. Removing the disposable gown after leaving the toddler's room is important for infection control but not specific to RSV care. Placing the toddler in a room with negative air pressure is not a standard practice for managing RSV in toddlers.

4. A client is receiving oxytocin to augment labor. The contractions are occurring every 45 seconds, and the fetal heart rate is 170-180 beats/min. What action should the nurse take?

• A. Increase the oxytocin infusion
• B. Decrease the oxytocin infusion
• C. Discontinue the oxytocin infusion
• D. Maintain the oxytocin infusion

Correct answer: C

Rationale: When contractions occur every 45 seconds with a high fetal heart rate, it indicates uterine hyperstimulation and fetal distress. In this situation, the oxytocin infusion should be discontinued immediately to prevent further complications. Increasing or maintaining the infusion would worsen the hyperstimulation and distress. Decreasing the infusion may not be sufficient to address the current situation and could still lead to complications.

5. A nurse is teaching a client with gestational diabetes about blood sugar control. Which of the following statements indicates understanding?

• A. I should test my blood sugar before each meal.
• B. I can eat any foods as long as I take my insulin.
• C. I should avoid all carbohydrates in my diet.
• D. I will only need to monitor my blood sugar at bedtime.

Correct answer: A

Rationale: The correct answer is A: 'I should test my blood sugar before each meal.' Monitoring blood sugar before meals is crucial for managing gestational diabetes as it helps in understanding how different foods affect blood sugar levels and adjusting insulin doses accordingly. Choice B is incorrect as food choices should be monitored carefully, not just relying on insulin. Choice C is incorrect because while it is important to manage carbohydrate intake, completely avoiding all carbohydrates is not recommended. Choice D is incorrect as blood sugar monitoring throughout the day is essential, not just at bedtime, to ensure proper control and management of gestational diabetes.

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