Nursing Elites

1. Following a blizzard that resulted in millions of dollars of damage, the community health nurse is planning to seek financial assistance for families affected by the disaster. Which contact is most important for the nurse to make?

• A. the governor's disaster relief program
• B. Federal Emergency Management Agency (FEMA)
• C. local churches that can provide shelter
• D. the community to seek volunteer contributions

Correct answer: B

Rationale: The correct answer is B, the Federal Emergency Management Agency (FEMA). FEMA is the primary agency responsible for providing financial assistance and support during disasters. While the governor's disaster relief program may also offer help, FEMA has more extensive resources and expertise in disaster response. Local churches providing shelter and seeking volunteer contributions from the community are valuable resources but may not offer the comprehensive financial assistance that FEMA can provide in such situations.

2. A government office worker is seen in the emergency room after opening an envelope containing a powder-like substance which is being tested for anthrax. Which discharge instruction should the nurse provide the client concerning inhalation anthrax?

• A. return to the emergency room if flu-like symptoms develop within 42 days
• B. notify co-workers to get the anthrax vaccine at the public health department
• C. isolation from friends and family members is recommended for 3 weeks
• D. cleanse all surfaces touched with pre-moistened antibacterial wipes

Correct answer: A

Rationale: The correct answer is to instruct the client to return to the emergency room if flu-like symptoms develop within 42 days. Flu-like symptoms can be an early sign of inhalation anthrax, and prompt medical intervention is crucial. Choice B is incorrect because the focus should be on the affected individual seeking medical attention rather than vaccinating others. Choice C is incorrect as isolation from friends and family members is not a standard recommendation for inhalation anthrax. Choice D is also incorrect as cleansing surfaces is important for infection control but may not be the priority when facing potential exposure to anthrax.

3. The nurse is caring for a client with hyperthyroidism. Which assessment finding requires immediate intervention?

• A. Heart rate of 100 beats per minute.
• B. Blood pressure of 150/90 mm Hg.
• C. Respiratory rate of 24 breaths per minute.
• D. Weight loss of 5 pounds in one week.

Correct answer: D

Rationale: Weight loss of 5 pounds in one week in a client with hyperthyroidism is concerning as it may indicate severe hypermetabolism, leading to potential complications such as cardiac arrhythmias, muscle weakness, and other metabolic disturbances. Rapid weight loss in hyperthyroidism indicates an accelerated metabolic rate and increased energy expenditure, which can be detrimental to the client's health. The other assessment findings (heart rate of 100 beats per minute, blood pressure of 150/90 mm Hg, respiratory rate of 24 breaths per minute) are commonly seen in clients with hyperthyroidism and may not necessarily require immediate intervention unless they are significantly outside the normal range or causing distress to the client.

4. A 56-year-old female client is receiving intracavitary radiation via a radium implant. Which nurse should be assigned to care for this client?

• A. A nurse who is pregnant.
• B. A nurse with Marfan syndrome who is postmenopausal.
• C. A nurse with a cold.
• D. A nurse who is lactating.

Correct answer: B

Rationale: A nurse with Marfan syndrome who is postmenopausal can safely care for the client because Marfan syndrome does not affect the ability to care for this client, and postmenopausal status minimizes the risk of radiation exposure affecting reproductive health. Choice A is incorrect because pregnancy increases the risk of radiation exposure to the fetus. Choice C is incorrect because a nurse with a cold may have a compromised immune system and should not be exposed to radiation therapy. Choice D is incorrect because lactation can increase the risk of radiation exposure to breast tissue.

5. An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?

• A. Nonsteroidal anti-inflammatory agents.
• B. Antihistamines.
• C. Tricyclic antidepressants.
• D. Antibiotics.

Correct answer: C

Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.

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