Nursing Elites

1. An adult client tells the clinic nurse that he is susceptible to middle ear infections. About which risk factor related to infection of the ears does the nurse question this client?

• A. Loud music
• B. Use of power tools
• C. Occupational noise
• D. Exposure to cigarette smoke

Correct answer: D

Rationale: The correct answer is 'Exposure to cigarette smoke.' Otitis media (middle ear infection) is associated with various factors like colds, allergies, sore throats, and blockage of the eustachian tubes. Risk factors include exposure to cigarette smoke, youth (as otitis media is usually a childhood disease), congenital abnormalities, immune deficiencies, family history of otitis media, recent upper respiratory infections, and allergies. Choices A, B, and C (Loud music, Use of power tools, and Occupational noise) are more likely to cause hearing loss rather than being direct risk factors for middle ear infections.

2. A nurse is reading the report from the registered nurse for an initial home visit to a client with chronic obstructive pulmonary disease. The client was recently discharged from the hospital. Which type of database does the nurse read that contains this information from the client?

• A. Episodic
• B. Follow-up
• C. Emergency
• D. Complete

Correct answer: D

Rationale: The correct answer is 'Complete.' A complete database includes a full health history and physical examination, providing a comprehensive overview of the client's current and past health status. This type of database establishes a baseline for future assessments, making it essential for the nurse's initial home visit to understand the client's health needs thoroughly post-hospital discharge. It is typically gathered in primary care settings like clinics, private practices, college health services, women's health care agencies, visiting nurse agencies, or community health agencies. An episodic database focuses on a specific short-term issue or body system, which is not comprehensive enough for the initial home visit after hospital discharge. A follow-up database is used to monitor a known problem at regular intervals, not suitable for an initial assessment. An emergency database is swiftly collected during urgent situations, often while lifesaving measures are being carried out, and is not relevant for a post-hospital discharge home visit.

3. A sexually active married couple, discussing birth control methods with the nurse, expresses the need for a method that is convenient. Because the couple has told the nurse that family-planning goals have been met, which method of birth control does the nurse suggest?

• A. Diaphragm
• B. Sterilization
• C. Male condom
• D. Spermicide

Correct answer: B

Rationale: In this scenario, since the couple has indicated that their family-planning goals have been met, a permanent method of contraception like sterilization would be most suitable. Sterilization offers long-term effectiveness and convenience once the decision to stop having children is made. Options like the diaphragm, male condom, or spermicide are more suitable for temporary contraception or when the family-planning goals have not yet been achieved. Therefore, the correct answer is sterilization, as it aligns with the couple's need for a convenient and permanent birth control method.

4. An LPN is taking care of an elderly client who experiences the effects of Sundowner's Syndrome almost every evening. Which of these interventions implemented by the nurse would be the most helpful?

• A. Place a nightlight in the client's room.
• B. Administer the PRN sedative prescribed by the attending physician.
• C. Remind the client that the things and people they are seeing are not real and that they are safe.
• D. Turn on the TV or radio to a station the client enjoys.

Correct answer: A

Rationale: A nightlight will help reorient the client to his or her surroundings in the evening and nighttime hours. It is best not to challenge the reality of a client experiencing Sundowner's Syndrome, and sedatives may make the effects of the syndrome worse. Every effort should be made to keep the client's room calm, quiet, and peaceful, so noise should be kept to a minimum. Reminding the client that what they are experiencing is not real may cause distress and confusion, while turning on the TV or radio may add unnecessary stimulation instead of promoting a soothing environment.

5. When discussing birth control methods with a client, what major factor should a nurse focus on to provide the motivation needed for consistent implementation of a birth control method?

• A. Personal preference
• B. Work and home schedules
• C. Family planning goals
• D. Desire to have children in the future

Correct answer: A

Rationale: When discussing birth control methods with a client, a nurse should focus on the client's personal preference as a major factor that will provide the motivation needed for consistent implementation of a birth control method. Personal preference plays a key role in ensuring that the chosen method aligns with the client's lifestyle and values, increasing the likelihood of adherence. While work and home schedules, family planning goals, and the desire to have children in the future can influence the choice of birth control method, they are not the primary motivating factors for consistent implementation. Personal preference is crucial as it empowers the client to select a method that suits their individual needs and preferences, ultimately leading to better compliance and effectiveness.

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