Nursing Elites

1. If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?

• A. retrograde ejaculation
• B. decreased plasma testosterone
• C. hypertrophy of testicles
• D. state of euphoria

Correct answer: B

Rationale: In chronic renal failure, untreated, the client is at risk of developing decreased plasma testosterone. This condition leads to atrophy of the testicles and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure but can occur after transurethral resection of the prostate. The testicles atrophy in chronic renal failure; they do not hypertrophy. Additionally, chronic renal failure often leads to a state of depression, not euphoria.

2. Why is Kleinman's Explanatory Model of Health and Illness significant?

• A. it focuses on the health beliefs of a particular family.
• B. it highlights the impact of culture on health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is based on an educational approach.

Correct answer: C

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the influence of popular and folk domains on health perceptions. Kleinman distinguishes between disease, representing the biomedical view, and illness, reflecting individual understanding. The model underscores that cultural factors shape the significance of popular and folk influences on health beliefs. Choice A is incorrect as the model focuses on broader cultural influences, not individual family beliefs. Choice B is incorrect as it oversimplifies the model's emphasis on various cultural aspects. Choice D is incorrect as the model's significance lies in its cultural framework rather than an educational base.

3. The LPN receives a call from a mother caring for her eight-month-old infant. The mother describes that the child has a low-grade fever and has teeth breaking through the gums. Which of the following measures would be inappropriate to recommend to the mother?

• A. Allow the child to chew on a cooled teething ring.
• B. Massage the child's gums gently.
• C. Administer acetaminophen.
• D. Administer aspirin.

Correct answer: D

Rationale: Administering aspirin would be inappropriate in this situation. Aspirin should not be recommended for children due to the increased risk of Reye's syndrome, a serious condition. Choices A, B, and C are all appropriate measures for managing teething discomfort in infants. Allowing the child to chew on a cooled teething ring can help soothe the gums, massaging the child's gums gently can provide relief, and administering acetaminophen is a suitable option for pain relief in infants with teething discomfort. Aspirin is contraindicated in children with viral infections due to the risk of Reye's syndrome, a potentially fatal condition affecting the brain and liver. Therefore, recommending aspirin to the mother would not be appropriate in this case.

4. A nurse reviewing the physical assessment findings in a client's health care record notes documentation that the Phalen test caused numbness and burning. Which disorder does the nurse, on the basis of this finding, conclude that the client has?

• A. Scoliosis
• B. Bone deformity
• C. Heberden nodules
• D. Carpal tunnel syndrome

Correct answer: D

Rationale: The Phalen test is specifically used to assess for carpal tunnel syndrome. In this test, the client is asked to hold their hands back to back while flexing the wrists 90 degrees, which can reproduce the numbness and burning sensation experienced by individuals with carpal tunnel syndrome. Scoliosis is a condition characterized by abnormal lateral curvature of the spine, not related to the Phalen test. Bone deformity is a general term that does not specifically relate to the symptoms described. Heberden nodules are bony swellings that occur in osteoarthritis and are not assessed through the Phalen test.

5. A client with Kawasaki disease has bilateral congestion of the conjunctivae, dry cracked lips, a strawberry tongue, and edema of the hands and feet followed by desquamation of fingers and toes. Which of the following nursing measures is most appropriate to meet the expected outcome of positive body image?

• A. administering immune globulin intravenously
• B. assessing the extremities for edema, redness, and desquamation every 8 hours
• C. explaining progression of the disease to the client and their family
• D. assessing heart sounds and rhythm

Correct answer: C

Rationale: Explaining the progression of the disease to the client and their family is the most appropriate nursing measure to promote a positive body image. By educating them about when symptoms are expected to improve and resolve, they can understand that there will be no permanent disruption in physical appearance that could negatively impact body image. While administering immune globulin intravenously may be part of the treatment for Kawasaki disease, it does not directly address body image concerns. Assessing the extremities for edema, redness, and desquamation every 8 hours is important for monitoring the disease but does not directly impact body image. Assessing heart sounds and rhythm is crucial for monitoring cardiac effects of Kawasaki disease but is not directly related to promoting a positive body image.

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