Nursing Elites

1. When designing a program for young adults regarding safe sexual practices, which strategy might reach the greatest number in the target group?

• A. Web-based applications
• B. Print-based media such as newspapers
• C. Television advertisements
• D. Brochures in kiosks in malls

Correct answer: A

Rationale: Web-based applications are the most effective strategy for reaching young adults in the target group regarding safe sexual practices. Young adults today are highly engaged with mobile technology and the internet, making web-based applications the most accessible and convenient method to disseminate information. Print-based media like newspapers may not have the same reach and engagement among young adults. Television advertisements might reach a broader audience, but they may not be as targeted to the specific demographic of young adults. Brochures in kiosks in malls are less likely to reach a large number of young adults compared to web-based applications, which can be accessed anytime and anywhere through mobile devices.

2. A nurse is admitting a client who is in labor and at 38 weeks of gestation to the maternal newborn unit. The client has a history of herpes simplex virus 2 (HSV-2). Which of the following questions is most appropriate for the nurse to ask the client?

• A. Have your membranes ruptured?
• B. How far apart are your contractions?
• C. Do you have any active lesions?
• D. Are you positive for beta strep?

Correct answer: C

Rationale: The most appropriate question for the nurse to ask the client in this scenario is whether they have any active lesions. Active lesions from HSV-2 during labor increase the risk of neonatal transmission, which would necessitate a cesarean section to prevent the infant from contracting the virus during delivery. Asking about the presence of active lesions is crucial to determine the appropriate management and precautions needed to protect the newborn. Choices A, B, and D are not as pertinent in this situation and do not directly address the potential risk of neonatal transmission of HSV-2.

3. A nurse is caring for a client who has liver cirrhosis and ascites. Which of the following actions should the nurse take to monitor the effectiveness of the treatment?

• A. Measure the client’s abdominal girth daily
• B. Monitor the client’s hemoglobin level
• C. Administer lactulose as prescribed
• D. Weigh the client weekly

Correct answer: A

Rationale: Measuring the client’s abdominal girth daily is the most effective way to monitor the reduction of ascites and fluid retention in clients with liver cirrhosis. This measurement helps assess the effectiveness of treatment in managing ascites by monitoring changes in abdominal size. Monitoring the client’s hemoglobin level (Choice B) is not directly related to assessing the effectiveness of ascites treatment. Administering lactulose as prescribed (Choice C) is important in managing hepatic encephalopathy, not ascites. Weighing the client weekly (Choice D) may not provide real-time feedback on the reduction of ascites compared to daily abdominal girth measurements.

4. A client with a closed head injury has their eyes open when pressure is applied to the nail beds, and they exhibit adduction of the arms with flexion of the elbows and wrists. The client also moans with stimulation. What is the client's Glasgow Coma Score?

• A. 4
• B. 7 (comatose)
• C. 9
• D. 10

Correct answer: B

Rationale: The client's Glasgow Coma Score is 7. This is calculated by assigning 2 points for eye-opening to pain, 2 points for incomprehensible sounds, and 3 points for flexion posturing. Choices A, C, and D are incorrect. Choice A (4) would be the score if the client displayed decerebrate posturing instead of flexion posturing. Choice C (9) would be the score if the client exhibited eye-opening to speech, confused speech, and decorticate posturing. Choice D (10) would be the score if the client showed eye-opening spontaneously, oriented speech, and obeyed commands, which is not the case here.

5. A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

• A. Glomerular filtration rate of 14 mL/min
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A glomerular filtration rate (GFR) of 14 mL/min indicates severely impaired kidney function, often necessitating hemodialysis to support renal function and manage fluid and electrolyte balance. A BUN level of 16 mg/dL falls within the normal range (7-20 mg/dL) and does not specifically indicate the need for hemodialysis. Serum magnesium at 1.8 mg/dL and serum phosphorus at 4.0 mg/dL are also within normal ranges and do not typically prompt the immediate need for hemodialysis in chronic kidney disease.

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