Nursing Elites

1. What is the cause of meningitis that is fatal in half of the infected patients?

• A. Virus
• B. Bacteria
• C. Fungus
• D. Noninfectious agent

Correct answer: B

Rationale: Bacterial meningitis is caused by bacterial pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, Listeria monocytogenes, and Neisseria meningitidis. These bacteria commonly lead to acute onset meningitis, presenting with symptoms like fever, stiff neck, and altered consciousness. The statement that bacterial meningitis is fatal in about 50% of cases is accurate, making it a serious and life-threatening condition. Viruses can also cause meningitis, but they are not typically associated with the high fatality rate seen in bacterial meningitis. Fungal meningitis is less common and usually affects individuals with weakened immune systems. Noninfectious agents do not cause meningitis.

2. A healthcare professional is preparing to palpate and percuss a patient's abdomen as part of the assessment process. Which of these findings would cause the healthcare professional to immediately discontinue this part of the assessment?

• A. The patient states, 'That sounds like it might hurt me.'
• B. There is a pulsating mass on the upper middle abdomen.
• C. The patient has black, tarry stools and anemia.
• D. The patient has had an endoscopic procedure two days prior.

Correct answer: B

Rationale: A pulsating mass on the upper middle abdomen is indicative of a life-threatening aortic aneurysm. Palpating or percussing such an area can potentially cause the aneurysm to rupture, leading to severe internal bleeding and endangering the patient's life. Therefore, the healthcare professional should immediately discontinue the assessment to prevent any harm.\nChoice A is incorrect because the patient expressing concerns about the procedure does not necessarily indicate a life-threatening condition. Choice C describes symptoms that should be further investigated but do not pose an immediate threat during abdominal assessment. Choice D, a prior endoscopic procedure, is not a contraindication for palpation or percussion of the abdomen unless there are specific complications or conditions related to the procedure that would require caution.

3. A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which action by the nurse is appropriate?

• A. Schedule the patient for HCV genotype testing.
• B. Administer the HCV vaccine and immune globulin.
• C. Teach the patient about ribavirin (Rebetol) treatment.
• D. Explain that the infection will resolve over a few months.

Correct answer: A

Rationale: The correct action by the nurse is to schedule the patient for HCV genotype testing. Genotyping of HCV is crucial in determining the appropriate treatment regimen and guiding therapy decisions. Most patients with acute HCV infection progress to the chronic stage, so it is incorrect to inform the patient that the infection will resolve in a few months. There is no vaccine or immune globulin available for HCV, and ribavirin (Rebetol) is typically used for chronic HCV infection. Therefore, the nurse should prioritize genotyping to assist in treatment planning.

4. When caring for a patient with Parkinson's Disease, which of the following practices would not be included in the care plan?

• A. Decrease the calorie content of daily meals to avoid weight gain
• B. Allow the patient extra time to respond to questions and perform ADLs
• C. Use thickened liquids and a soft diet
• D. Encourage the patient to hold the spoon when eating

Correct answer: A

Rationale: The correct answer is to decrease the calorie content of daily meals to avoid weight gain. Patients with Parkinson's Disease often experience dysphagia (difficulty swallowing) and muscle rigidity, which can lead to weight loss. Therefore, increasing calorie intake is essential to meet their nutritional needs. Choice A is incorrect because reducing calories can worsen malnutrition in these patients. Choices B, C, and D are appropriate interventions for patients with Parkinson's Disease. Allowing extra time for tasks, using thickened liquids and a soft diet for swallowing difficulties, and encouraging self-feeding promote independence and safety in eating.

5. While caring for the client during the first hour after delivery, the nurse determines that the uterus is boggy and there is vaginal bleeding. What should be the nurse's first action?

• A. Check vital signs.
• B. Massage the fundus.
• C. Offer a bedpan.
• D. Check for perineal lacerations.

Correct answer: B

Rationale: The nurse's first action should be to massage the fundus until it is firm as uterine atony is the primary cause of bleeding in the first hour after delivery. Massaging the fundus helps to stimulate uterine contractions, which can help control the bleeding. Checking vital signs would be important but addressing the primary cause of bleeding takes precedence. Offering a bedpan is not a priority in this situation as the focus should be on managing the postpartum bleeding. Checking for perineal lacerations is also important but not the initial action needed to address the boggy uterus and vaginal bleeding.

Similar Questions