Nursing Elites

1. A patient asks a nurse the following question: Exposure to TB can be best identified with which of the following procedures?

• A. Chest x-ray
• B. Mantoux test
• C. Breath sounds examination
• D. Sputum culture for Mycobacterium tuberculosis

Correct answer: B

Rationale: The Mantoux test, also known as the tuberculin skin test, is the most appropriate and accurate test to identify exposure to TB. This test involves injecting a small amount of PPD tuberculin under the top layer of the skin, and a positive reaction indicates exposure to the TB bacteria. Choice A, a chest x-ray, is useful for detecting active TB disease but not exposure. Choice C, a breath sounds examination, is not a specific test for TB exposure. Choice D, a sputum culture for Mycobacterium tuberculosis, is used to diagnose active TB infection rather than exposure.

2. Post thyroidectomy the nurse assesses for complications by performing which of the following assessments?

• A. Accu-Chek
• B. Chvostek's
• C. Ballottement
• D. Ice water colonic

Correct answer: B

Rationale: The correct answer is Chvostek's. A positive Chvostek's and Trousseau's sign is indicative of tetany, which is associated with low calcium levels. This can occur if parathyroid glands are accidentally removed during thyroidectomy. Accu-Chek is a brand of blood glucose monitor used for checking blood sugar levels and is not relevant in this context. Ballottement is a technique used in physical examination to assess for fluid in the body, typically in the abdomen or joints. Ice water colonic is not a standard medical assessment and is not relevant to post-thyroidectomy complications.

3. How can light therapy be effective?

• A. overcoming weight problems.
• B. helping with allergies.
• C. use in alternative medical treatments.
• D. working with sleep patterns.

Correct answer: D

Rationale: Light therapy can be effective in treating problems associated with sleep patterns, stress, moods, jaundice in newborns, and seasonal affective disorders. While light therapy is not typically used for overcoming weight problems or helping with allergies, it is specifically known for its benefits in regulating sleep patterns. Therefore, the correct answer is 'working with sleep patterns.' Choices A, B, and C are incorrect as light therapy is not commonly utilized for overcoming weight problems, helping with allergies, or as a general alternative medical treatment.

4. Which nursing diagnosis has the highest priority for a client with insomnia?

• A. Ineffective breathing pattern
• B. Disturbed sensory perception
• C. Ineffective coping
• D. Sleep deprivation

Correct answer: A

Rationale: The correct answer is 'A: Ineffective breathing pattern.' When a client presents with insomnia, assessing for underlying causes is crucial. Sleep apnea, an airway issue, may be a contributing factor to the client's insomnia, making 'Ineffective breathing pattern' the priority. 'Disturbed sensory perception' focuses on alterations in touch, taste, or vision, which are not directly related to insomnia. 'Ineffective coping' addresses a client's inability to manage stress, which, although important, is not the priority in this case. 'Sleep deprivation' is a consequence of insomnia rather than a primary nursing diagnosis.

5. The client is undergoing an induction for fetal demise at 34 weeks. Immediately after delivery, the mother asks to see the infant. What is the nurse's best response?

• A. Bring the swaddled fetus to the mother
• B. Explain that the cause of death must be determined before she can see the baby
• C. Ask her if she is sure she wants to see the baby
• D. Tell her it would be better to wait until she is in her room before she sees the baby

Correct answer: A

Rationale: The nurse should bring the swaddled fetus to the mother as the best response. Allowing the mother to see the infant immediately after delivery is crucial for her grieving process. It provides her with the opportunity to bond, say goodbye, and start the grieving process. Choice B is incorrect because delaying the mother's request to see the baby can hinder her grieving process and prolong her suffering. Choice C is inappropriate as it questions the mother's decision at a sensitive time, potentially causing distress. Choice D is also not the best response as it suggests waiting, which may not be in the mother's best interest at that moment, as she needs immediate support and closure.

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