Nursing Elites

1. A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, "I need this surgery because nothing else I have done has helped me to lose weight."? Which response by the nurse is most appropriate?

• A. "If you eat less, you can save some money."?
• B. "Exercise is a healthier way to lose weight."?
• C. "You should try the Atkins diet first."?
• D. "I respect your decision to choose surgery."?

Correct answer: D

Rationale: The most appropriate response by the nurse is to show respect and empathy towards the client's decision. Option D acknowledges the client's autonomy and decision-making process, fostering a therapeutic relationship. Options A, B, and C are insensitive and unprofessional. Option A implies a financial incentive for weight loss, which can be perceived as disrespectful and trivializing the client's concerns. Option B suggests an alternative method without considering the client's reasons for choosing surgery, potentially invalidating her experiences. Option C recommends a specific diet without addressing the client's concerns or choices, neglecting her autonomy in decision-making.

2. A patient has just been prescribed Minipress to control hypertension. The nurse should instruct the patient to be observant of the following:

• A. Dizziness and light-headed sensations
• B. Weight gain
• C. Sensory changes in the lower extremities
• D. Fatigue

Correct answer: A

Rationale: The correct answer is 'Dizziness and light-headed sensations.' Minipress, a medication used to control hypertension, can cause hypotension as a side effect. Dizziness and light-headed sensations are common symptoms of hypotension. Weight gain, sensory changes in the lower extremities, and fatigue are not typically associated with Minipress or hypertension management. Therefore, they are incorrect choices.

3. Which infection control measure is the priority for the nurse to implement in the care provided for a child admitted to the hospital with bacterial meningitis?

• A. Place the child in a private room
• B. Gowns and masks must be worn by all personnel in the child's room
• C. Visitors are restricted to parents only
• D. Hand washing is required by all personnel and visitors having contact with the child

Correct answer: B

Rationale: The priority control measure for the nurse to implement in caring for a child with bacterial meningitis is ensuring that gowns and masks are worn by all personnel in the child's room. This measure is crucial as the child with bacterial meningitis is contagious for at least 24 hours after starting antibiotics, necessitating airborne precautions to prevent the spread of infection to healthcare workers and other patients. Placing the child in a private room (Choice A) is important but secondary to preventing infection transmission. Restricting visitors to parents only (Choice C) is also significant but not as critical as ensuring proper infection control measures. While hand washing (Choice D) is essential, the immediate need to prevent airborne transmission in the child's room takes precedence.

4. The nurse is caring for a 44-year-old client diagnosed with hypoparathyroidism. Which electrolyte imbalance is closely associated with hypoparathyroidism?

• A. Hypocalcemia.
• B. Hyponatremia.
• C. Hyperkalemia.
• D. Hypophosphatemia.

Correct answer: A.

Rationale: The correct answer is Hypocalcemia. In hypoparathyroidism, where the parathyroid glands are not producing sufficient parathyroid hormone, calcium levels become inadequate. This leads to hypocalcemia, characterized by symptoms such as muscle spasms, anxiety, seizures, hypotension, and congestive heart failure. Hyponatremia and hyperkalemia are not typically associated with hypoparathyroidism. While hyperphosphatemia can be seen in hypoparathyroidism due to decreasing calcium levels, the question specifically asks about the primary electrolyte imbalance closely related to hypoparathyroidism, which is hypocalcemia.

5. The anemias most often associated with pregnancy are:

• A. folic acid and iron deficiency.
• B. folic acid deficiency and thalassemia.
• C. iron deficiency and thalassemia.
• D. thalassemia and B12 deficiency.

Correct answer: B

Rationale: Folic acid and iron deficiency anemia are the most common types of anemia associated with pregnancy. Approximately 50% of pregnant women experience this type of anemia. Iron deficiency anemia during pregnancy typically results from the increased plasma volume, rather than a decrease in iron levels. Moreover, if a woman has iron deficiency anemia before pregnancy, it often worsens during pregnancy. Folic acid deficiency is also prevalent during pregnancy due to the increased demand for this nutrient to support fetal development. Thalassemia and B12 deficiency, while types of anemia, are not as commonly associated with pregnancy compared to folic acid and iron deficiency anemia, making them incorrect choices in this context.

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