Nursing Elites

1. A nurse is admitting a client who has meningococcal meningitis. What should the nurse do first?

• A. Initiate droplet precautions
• B. Start intravenous antibiotics
• C. Perform a complete assessment
• D. Notify the healthcare provider

Correct answer: A

Rationale: The first priority when admitting a client with meningococcal meningitis is to initiate droplet precautions. This is essential to prevent the transmission of the infection to others, as meningococcal meningitis is highly contagious through respiratory droplets. Starting intravenous antibiotics or performing a complete assessment can follow, but the immediate concern is to implement infection control measures. Notifying the healthcare provider should also be done but is not the first action to take in this situation.

2. A client with burn injuries covering their upper body is concerned about their altered appearance. Which of the following statements should the nurse make?

• A. “It is okay to not want to touch the burned areas of your body.”
• B. “Cosmetic surgery should be performed within the next year to be effective.”
• C. “Reconstructive surgery can completely restore your previous appearance.”
• D. “It could be helpful for you to attend a support group for people who have burn injuries.”

Correct answer: D

Rationale: The nurse should encourage the client to attend a support group for individuals with burn injuries. Support groups can provide emotional support, promote acceptance of altered appearance, and help the client cope with the changes. Choice A is incorrect because it may not address the client's emotional needs. Choice B is incorrect as suggesting a timeline for cosmetic surgery may not be appropriate without considering the client's physical and emotional readiness. Choice C is incorrect as reconstructive surgery may not completely restore the client's previous appearance and may set unrealistic expectations.

3. Using Naegele's Rule, what is the estimated delivery date for a pregnant client whose last menstrual period was on May 4th, 2013?

• A. January 15, 2014
• B. February 11, 2014
• C. March 3, 2014
• D. December 25, 2013

Correct answer: B

Rationale: Naegele's rule is a standard method for calculating the estimated delivery date (EDD). It involves subtracting three months from the first day of the last menstrual period (LMP), adding seven days, and then adding one year. For a client with an LMP of May 4th, 2013, subtracting three months gives February 4th. Adding seven days results in a due date of February 11th, 2014, which is the correct answer. Choice A (January 15, 2014) is incorrect as it does not account for the full calculation. Choice C (March 3, 2014) is incorrect as it adds too many days in the calculation. Choice D (December 25, 2013) is incorrect as it does not follow the correct steps of Naegele's rule.

4. A nurse is assessing a client with chronic kidney disease. Which of the following findings should the nurse monitor?

• A. Hypokalemia
• B. Fluid overload
• C. Decreased blood pressure
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Fluid overload. Clients with chronic kidney disease are prone to fluid overload due to impaired kidney function. The kidneys may not effectively regulate fluid balance, leading to fluid retention. Monitoring for signs of fluid overload, such as edema, hypertension, and shortness of breath, is crucial. Choice A, Hypokalemia, is less likely in chronic kidney disease as the kidneys often have difficulty excreting potassium, leading to hyperkalemia. Decreased blood pressure (Choice C) is not a common finding in chronic kidney disease unless complications like volume depletion occur. Increased appetite (Choice D) is not typically associated with chronic kidney disease; in fact, many clients may experience a decreased appetite due to various factors such as uremia and dietary restrictions.

5. A client is receiving morphine. Which of the following should the nurse monitor?

• A. Liver function
• B. Respiratory rate
• C. Blood glucose levels
• D. Bowel sounds

Correct answer: B

Rationale: Corrected Rationale: When a client is receiving morphine, monitoring the respiratory rate is crucial because morphine can cause respiratory depression. Therefore, it is essential for the nurse to assess the client's breathing to detect any signs of respiratory distress. Choices A, C, and D are incorrect because morphine primarily affects the respiratory system, not the liver function, blood glucose levels, or bowel sounds.

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