Nursing Elites

1. A healthcare professional is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?

• A. S. pneumoniae
• B. H. influenzae
• C. N. meningitidis
• D. Cl. difficile

Correct answer: D

Rationale: The correct answer is Cl. difficile. Clostridium difficile (C. diff) is not typically associated with meningitis in humans. This bacterium is known to cause severe diarrhea, usually as a result of antibiotic treatment. S. pneumoniae, H. influenzae, and N. meningitidis are all known to be causative agents of meningitis in humans. S. pneumoniae is a common cause of bacterial meningitis, especially in adults. H. influenzae, particularly type b (Hib), used to be a leading cause of meningitis in children before the introduction of the Hib vaccine. N. meningitidis is another significant pathogen responsible for causing meningitis, especially in young adults and adolescents.

2. Which of the following techniques can help to prevent skin irritation or breakdown around a tracheostomy site?

• A. Manage secretions by providing suction on a regular basis
• B. Cleanse the site daily with a mixture of povidone-iodine and water
• C. Avoid using tube ties to secure the tube
• D. None of the above

Correct answer: A

Rationale: Excess secretions from the tracheostomy tube can collect near the stomal opening and cause skin breakdown. Management of secretions through regular suctioning will keep the area clean and dry, minimizing skin irritation. Choice B, cleansing the site daily with povidone-iodine and water, is incorrect as it may lead to skin irritation due to the harshness of povidone-iodine. Choice C, avoiding tube ties to secure the tube, is also incorrect as securing the tube is essential for stability. Choice D, 'None of the above,' is incorrect as managing secretions through suctioning is crucial in preventing skin irritation.

3. A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client's temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is:

• A. Maintain fluid and electrolyte balance
• B. Control nausea
• C. Manage pain
• D. Prevent urinary tract infection

Correct answer: C

Rationale: In the scenario presented, the priority nursing goal for a client with renal calculi experiencing moderate to severe flank pain and nausea should be to manage pain. Pain management is crucial as it alleviates suffering, improves comfort, and enhances the quality of life for the client. In the case of ureteral colic from renal calculi, the cornerstone of management is effective pain control. Prompt analgesia, typically achieved with parenteral narcotics or nonsteroidal anti-inflammatory drugs (NSAIDs), is essential to provide relief and facilitate the passage of the calculi. While maintaining fluid and electrolyte balance is important in clients with renal calculi, addressing pain takes precedence as it directly impacts the client's immediate well-being. Controlling nausea and preventing urinary tract infections are also important aspects of care, but they are secondary to managing the primary concern of pain in this urgent situation.

4. A patient has taken an overdose of aspirin. Which of the following should a nurse closely monitor during acute management of this patient?

• A. Onset of pulmonary edema
• B. Metabolic alkalosis
• C. Respiratory alkalosis
• D. Parkinson's disease type symptoms

Correct answer: A

Rationale: The correct answer is to monitor the onset of pulmonary edema. In cases of aspirin overdose, metabolic acidosis is a common consequence that can lead to the development of pulmonary edema. Early signs of aspirin poisoning include symptoms like tinnitus, hyperventilation, vomiting, dehydration, and fever. Late signs may manifest as drowsiness, bizarre behavior, unsteady walking, and coma. Aspirin poisoning can cause abnormal breathing that is typically rapid and deep. Pulmonary edema may occur due to increased capillary permeability in the lungs, leading to the leakage of proteins and fluid transudation in renal and pulmonary tissues. Changes in renal tubule permeability can also affect colloid osmotic pressure, potentially contributing to pulmonary edema. Monitoring pulmonary edema is crucial in managing aspirin overdose cases to prevent further complications. Choices B, C, and D are incorrect because metabolic alkalosis, respiratory alkalosis, and Parkinson's disease type symptoms are not typically associated with aspirin overdose and are not primary concerns in its acute management.

5. What is the primary nursing concern when caring for patients being treated with splints, casts, or traction?

• A. To assess for and prevent neurovascular complications or dysfunction
• B. To ensure adequate nutrition during the healing process
• C. To provide patient education for maintenance of splints, casts, or traction in the community
• D. To treat acute pain

Correct answer: A

Rationale: The primary nursing concern when caring for patients with splints, casts, or traction is to assess for and prevent neurovascular complications or dysfunction. This is crucial to ensure adequate circulation and nerve function, preventing long-term complications such as ischemia or nerve damage. While adequate nutrition and patient education are important aspects of care, they are not the primary concern in this scenario. Acute pain management is important but is secondary to preventing neurovascular complications in patients treated with splints, casts, or traction.

Similar Questions