Nursing Elites

1. What is the primary focus of a case manager?

• A. Addressing nursing care needs at discharge.
• B. Managing the comprehensive care needs of the client for continuity of care.
• C. Providing client education needs upon discharge.
• D. Securing financial resources for needed care.

Correct answer: B

Rationale: The correct answer is 'Managing the comprehensive care needs of the client for continuity of care.' Case managers oversee all aspects of a client's care to ensure continuity throughout their healthcare journey. Choice A is incorrect as it focuses only on nursing care needs at discharge, which is just a part of the overall care needed. Choice C narrows down the focus to client education needs, excluding other essential care components. Choice D solely considers financial resources, neglecting the broader scope of care needs that a case manager is accountable for.

2. How often should a 5-year-old child undergo a dental examination?

• A. Every 6 months
• B. Whenever a new primary tooth erupts
• C. Once a year
• D. Every 3 months

Correct answer: A

Rationale: For a 5-year-old child, dental examinations should be conducted every 6 months. This frequency allows for early detection of dental issues and promotes good oral health. Choices B, C, and D are incorrect because waiting for a new primary tooth to erupt, having an examination once a year, or every 3 months are not the recommended intervals for dental check-ups in this age group. It is essential to adhere to the standard guideline of every 6 months to ensure regular monitoring and preventive care for the child's dental health.

3. An LPN is taking care of an elderly client who experiences the effects of Sundowner's Syndrome almost every evening. Which of these interventions implemented by the nurse would be the most helpful?

• A. Place a nightlight in the client's room.
• B. Administer the PRN sedative prescribed by the attending physician.
• C. Remind the client that the things and people they are seeing are not real and that they are safe.
• D. Turn on the TV or radio to a station the client enjoys.

Correct answer: A

Rationale: A nightlight will help reorient the client to his or her surroundings in the evening and nighttime hours. It is best not to challenge the reality of a client experiencing Sundowner's Syndrome, and sedatives may make the effects of the syndrome worse. Every effort should be made to keep the client's room calm, quiet, and peaceful, so noise should be kept to a minimum. Reminding the client that what they are experiencing is not real may cause distress and confusion, while turning on the TV or radio may add unnecessary stimulation instead of promoting a soothing environment.

4. A nurse is caring for an older client who has a bronchopulmonary infection. The nurse monitors the client's ability to maintain a patent airway because of which factor involved in the normal aging process?

• A. Increased respiratory system compliance
• B. Decreased number of alveoli and increased function of those remaining
• C. Decreased older client's ability to clear secretions
• D. Increased production of surfactant

Correct answer: C

Rationale: The correct answer is 'Decreased older client's ability to clear secretions.' Respiratory changes related to the normal aging process decrease an older adult's ability to clear secretions and protect the airway. In healthy older adults, the number of alveoli does not change significantly; their structure, however, is altered. Respiratory system compliance decreases with advancing age because of a progressive loss of elastic recoil of the lung parenchyma and conducting airways, and reduced elastic recoil of the lung and opposing forces of the chest wall. Production of surfactant in the lung does not usually decrease with aging, nor does it increase. However, the production of alveolar cells responsible for surfactant production is diminished. Choices A, B, and D are incorrect. Choice A is incorrect because respiratory system compliance decreases with aging. Choice B is incorrect as the number of alveoli does not significantly decrease in healthy older adults. Choice D is incorrect as the production of surfactant does not usually decrease with aging.

5. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

• A. a radiologist
• B. a gynecologist
• C. a physiatrist
• D. an oncologist

Correct answer: B

Rationale: A 65-year-old female experiencing postmenopausal bleeding should be encouraged to see a gynecologist. Gynecologists specialize in treating and managing diseases of the female reproductive organs, making them the most appropriate physician for this issue. Postmenopausal bleeding can indicate various gynecological conditions such as endometrial atrophy, endometrial hyperplasia, or endometrial cancer, highlighting the importance of consulting a gynecologist for proper diagnosis and management. Radiologists evaluate X-rays, physiatrists manage rehabilitation teams, and oncologists treat clients with cancer. Therefore, in this case, the symptoms point towards a gynecological problem, emphasizing the necessity of seeking care from a gynecologist.

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