Nursing Elites

1. To identify risk factors associated with the use of an oral contraceptive, which question should the nurse ask a client providing subjective data?

• A. Do you normally experience menstrual cramps with your periods?
• B. Do you smoke cigarettes?
• C. Are you currently dieting?
• D. Do you engage in strenuous exercise, such as jogging?

Correct answer: B

Rationale: The correct question the nurse should ask to identify risk factors associated with the use of an oral contraceptive is whether the client smokes cigarettes. Oral contraceptives are associated with an increased risk of thromboembolic phenomena, particularly when combined with other risk factors like smoking and a history of thrombosis. Other risk factors include hypertension, cerebrovascular disease, coronary artery disease, and postoperative thrombosis risk. Choices A, C, and D are not directly related to the increased risks associated with oral contraceptive use. Menstrual cramps, dieting, and strenuous exercise are not significant risk factors for thromboembolic events.

2. While assessing for costovertebral angle tenderness, a nurse percusses the area, and the client complains of sharp pain. The nurse interprets this finding as most indicative of which disorder?

• A. Liver enlargement
• B. Ovarian infection
• C. Spleen enlargement
• D. Kidney inflammation

Correct answer: D

Rationale: When assessing for costovertebral angle tenderness, sharp pain on percussion of the area indicates inflammation of the kidney or paranephric area. The correct technique involves placing one hand over the 12th rib, at the costovertebral angle, and thumping that hand with the ulnar edge of the other fist. The client normally feels a thud and should not experience pain. Ovarian infection, liver enlargement, or spleen enlargement are not associated with the costovertebral angle tenderness. Therefore, the correct answer is kidney inflammation.

3. What is one of the main goals of Healthy People 2010?

• A. reduction of health care costs
• B. elimination of health disparities
• C. investigation of substance abuse
• D. determination of an acceptable morbidity rate

Correct answer: C

Rationale: The main goal of Healthy People 2010 is the elimination of health disparities among the U.S. population. This initiative outlines specific objectives to improve the overall health of Americans by addressing disparities in health outcomes. Choice A, reduction of health care costs, is not the primary goal of Healthy People 2010, although it may be a beneficial outcome. Choice C, investigation of substance abuse, is not a main goal of Healthy People 2010; while substance abuse may be a factor in health disparities, the primary focus is on broader disparities. Choice D, determination of an acceptable morbidity rate, is not the main focus of Healthy People 2010; instead, it aims to address health disparities in different population groups.

4. Client self-determination is the primary focus of:

• A. malpractice insurance.
• B. nursing's advocacy for clients.
• C. confidentiality.
• D. health care.

Correct answer: B

Rationale: Client self-determination is the primary focus of nursing's advocacy for clients. Nurses advocate for their clients' right to autonomy and self-determination, ensuring that the clients' preferences and choices are respected. Confidentiality, on the other hand, involves maintaining the privacy of the client and their information. Health care is a broad term encompassing various aspects of medical services. Malpractice insurance is a type of insurance that provides coverage for professionals in case of negligence or malpractice, not directly related to client self-determination.

5. A nurse in the newborn nursery, assisting with data collection for a newborn, prepares to measure the chest circumference. The nurse places the tape measure around the infant at which location?

• A. In the axillary area
• B. At the level of the nipples
• C. Two inches below the nipples
• D. At the level of the umbilicus

Correct answer: B

Rationale: The chest circumference of the infant is measured at the level of the nipples. It is usually 2 to 3 cm smaller than the head circumference. The average chest circumference is 30.5 to 33 cm (12-13 inches). When there is molding of the head, the head and chest measurements may be equal at birth. Placing the tape measure at the level of the nipples ensures accuracy and consistency in newborn assessment. Options A, C, and D are incorrect as the chest circumference is specifically measured at the level of the nipples to obtain precise measurements.

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