Nursing Elites

1. A recently widowed middle-aged female client presents to the psychiatric clinic for evaluation and tells the nurse that she has 'little reason to live.' She describes one previous suicidal gesture and admits to having a gun in her home. To maintain the client's confidentiality and to help ensure her safety, which action is best for the nurse to implement?

• A. Encourage the client to remove the gun from her possession.
• B. Notify the client's healthcare provider of the availability of the weapon.
• C. Contact a person of the client's choosing to remove the weapon from the home.
• D. Call the local police department and have the weapon removed from the home.

Correct answer: C

Rationale: In this scenario, it is crucial to maintain the client's confidentiality while ensuring her safety. Contacting a person chosen by the client to remove the weapon from her home is the best course of action. This approach respects the client's autonomy and helps reduce the risk of harm without involving external authorities unnecessarily.

2. A client is admitted with suspected meningitis. Which assessment finding requires immediate intervention?

• A. Headache.
• B. Fever.
• C. Nuchal rigidity.
• D. Seizures.

Correct answer: D

Rationale: Seizures in a client with suspected meningitis indicate increased intracranial pressure or other complications requiring immediate intervention. Seizures can lead to further neurological damage and need prompt management to prevent adverse outcomes. Therefore, addressing seizures promptly is crucial in the care of a client with suspected meningitis.

3. What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?

• A. Preventing infection
• B. Controlling bleeding
• C. Reducing portal hypertension
• D. Maintaining nutritional status

Correct answer: B

Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. Esophageal varices are fragile, enlarged veins in the esophagus that can rupture and lead to life-threatening bleeding. Controlling bleeding is crucial to prevent severe complications and ensure the client's safety and well-being. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal that may help prevent variceal bleeding but is not the immediate priority. Maintaining nutritional status (Choice D) is essential for overall health but is secondary to controlling bleeding in this critical situation.

4. The client with newly diagnosed osteoporosis is being taught by the nurse about dietary modifications. Which instruction should the nurse include?

• A. Increase your intake of high-calcium foods.
• B. Limit your intake of vitamin D-rich foods.
• C. Avoid foods high in phosphorus.
• D. Increase your intake of high-sodium foods.

Correct answer: A

Rationale: Increasing the intake of high-calcium foods is essential for improving bone density and managing osteoporosis. Calcium is a key mineral necessary for bone health, and individuals with osteoporosis often need higher levels of calcium to help strengthen their bones and prevent further bone loss. Therefore, advising the client to increase their intake of high-calcium foods is the most appropriate dietary modification to support their bone health.

5. A 60-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. What is the most likely diagnosis?

• A. Hepatitis C
• B. Primary biliary cirrhosis
• C. Hemochromatosis
• D. Wilson's disease

Correct answer: B

Rationale: The symptoms of fatigue, pruritus, jaundice, and elevated bilirubin and alkaline phosphatase levels are classic features of primary biliary cirrhosis, an autoimmune liver disease. Hepatitis C typically presents with different symptoms and findings, such as specific viral markers. Hemochromatosis and Wilson's disease involve iron overload and copper accumulation, respectively, leading to distinct clinical and laboratory findings, which do not match the presentation described in this case.

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