Nursing Elites

1. Septic, anaphylactic, and neurogenic shock are all categorized as:

• A. Hypovolemic shock
• B. Cardiogenic shock
• C. Distributive shock
• D. Obstructive shock

Correct answer: C

Rationale: Septic, anaphylactic, and neurogenic shock are all types of distributive shock. Distributive shock is characterized by a decrease in systemic vascular resistance, leading to poor tissue perfusion. Septic shock is caused by severe infection, anaphylactic shock is an extreme allergic reaction, and neurogenic shock results from damage to the nervous system. Hypovolemic shock (Choice A) is characterized by a decrease in intravascular volume, cardiogenic shock (Choice B) is due to heart failure, and obstructive shock (Choice D) results from obstruction of blood flow. Therefore, the correct categorization for septic, anaphylactic, and neurogenic shock is distributive shock.

2. A patient with right lower-lobe pneumonia has been treated with IV antibiotics for 3 days. Which assessment data obtained by the nurse indicates that the treatment has been effective?

• A. Bronchial breath sounds are heard at the right base.
• B. The patient coughs up small amounts of green mucus.
• C. The patients white blood cell (WBC) count is 9000/L
• D. Increased tactile fremitus is palpable over the right chest

Correct answer: C

Rationale: The normal WBC count indicates that the antibiotics have been effective. All the other data suggest that a change in treatment is needed.

3. The nurse is discussing negativism with the parents of a 30-month-old child. How should the nurse advise the parents to best respond to this behavior?

• A. Reprimand the child and give a 15-minute 'time out'
• B. Maintain a permissive attitude for this behavior
• C. Use patience and a sense of humor to deal with this behavior
• D. Assert authority over the child through limit setting

Correct answer: C

Rationale: Use patience and a sense of humor to deal with this behavior. The nurse should help the parents understand that negativism is a normal part of a toddler's growth towards autonomy. Reacting with patience and humor can help diffuse the situation and maintain a positive relationship with the child. Reprimanding the child and giving a 'time out' (Choice A) may not be effective for addressing negativism and can lead to power struggles. Maintaining a permissive attitude (Choice B) may reinforce negative behavior. Asserting authority through limit setting (Choice D) may be necessary in some situations, but using patience and humor is a more effective initial approach for handling negativism.

4. Which of the following diseases is caused by the Bordetella pertussis bacterium?

• A. German Measles
• B. RSV
• C. Meningitis
• D. Whooping Cough

Correct answer: D

Rationale: Bordetella pertussis is the bacterium responsible for causing Whooping Cough, also known as pertussis. Meningitis can be caused by various bacteria, but not specifically by Bordetella pertussis. German Measles, also known as Rubella, and RSV (Respiratory Syncytial Virus) are viral infections and are not caused by the Bordetella pertussis bacterium. Therefore, the correct answer is Whooping Cough, caused by Bordetella pertussis.

5. Following a diagnosis of acute glomerulonephritis (AGN) in their 6-year-old child, the parent's remark: "We just don't know how he caught the disease!"? The nurse's response is based on an understanding that:

• A. AGN is a streptococcal infection that involves the kidney tubules.
• B. The disease is easily transmissible in schools and camps.
• C. The illness is usually associated with chronic respiratory infections.
• D. It is not "caught"? but is a response to a previous B-hemolytic strep infection.

Correct answer: D

Rationale: The correct answer is that acute glomerulonephritis (AGN) is not 'caught' but is a response to a previous B-hemolytic strep infection. AGN is generally accepted as an immune-complex disease triggered by an antecedent streptococcal infection occurring 4 to 6 weeks prior. It is considered a noninfectious renal disease. Choice A is incorrect because AGN is not a streptococcal infection that involves the kidney tubules but rather a noninfectious renal disease. Choice B is incorrect as AGN is not easily transmissible in schools and camps but is a result of a previous streptococcal infection. Choice C is incorrect as AGN is not usually associated with chronic respiratory infections, but with a previous streptococcal infection.

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