Nursing Elites

1. The priority goal for a family who practices Chinese medicine would be to:

• A. Achieve harmony
• B. Maintain a balance of energy
• C. Respect life
• D. Restore yin and yang

Correct answer: D

Rationale: In Chinese medicine, the concept of yin and yang represents the balance of opposing forces in the body. When there is an imbalance between yin and yang, it can result in illness. Therefore, the priority goal for a family practicing Chinese medicine would be to restore the harmony and balance between yin and yang. Choices A, B, and C are not the priority goal in Chinese medicine. While achieving harmony, maintaining a balance of energy, and respecting life are important aspects of Chinese medicine, the fundamental principle revolves around maintaining the equilibrium of yin and yang for optimal health.

2. A client is admitted with the diagnosis of pulmonary embolism. While taking a history, the client tells the nurse he was admitted for the same thing twice before, the last time just 3 months ago. The nurse would anticipate the healthcare provider ordering:

• A. Pulmonary embolectomy
• B. Vena caval interruption
• C. Increasing the coumadin therapy to achieve an INR of 3-4
• D. Thrombolytic therapy

Correct answer: B

Rationale: In the case of a client with a history of recurrent pulmonary embolism or contraindications to heparin, vena caval interruption may be necessary. Vena caval interruption involves placing a filter device in the inferior vena cava to prevent clots from traveling to the pulmonary circulation. Pulmonary embolectomy is a surgical procedure to remove a clot from the pulmonary artery, which is usually considered in severe or life-threatening cases. Increasing coumadin therapy to achieve a higher INR may be an option but vena caval interruption would be more appropriate in this scenario. Thrombolytic therapy is used in acute cases of pulmonary embolism to dissolve the clot rapidly, but in a recurrent case with contraindications to anticoagulants, vena caval interruption would be a preferred intervention.

3. Research participants are involved in a trial that incidentally separates them into two groups. One group receives an intervention, while the other group does not. Both groups are compared for outcomes. What type of research method is this?

• A. Experimental design
• B. Double-blind experiment
• C. Randomized controlled trial
• D. Repeated measures design

Correct answer: C

Rationale: A randomized controlled trial is a research method in which participants are randomly assigned to either a treatment or control group. This design helps eliminate bias and allows for the comparison of outcomes between the two groups. In this scenario, where participants are separated into intervention and non-intervention groups for comparison, it aligns with the characteristics of a randomized controlled trial. The key feature distinguishing it from the other options is the random assignment of participants to groups, ensuring that both groups are comparable at the start of the study. Double-blind experiments involve blinding both participants and researchers to treatment allocation, which is not explicitly mentioned in the scenario. Experimental design refers to a broader category that includes various types of research designs beyond just randomized controlled trials. Repeated measures design involves collecting multiple observations from the same participants over time, which is not the case described in the scenario.

4. The mother of a 2-month-old infant brings the child to the clinic for a well-baby check. She is concerned because she feels only one testis in the scrotal sac. Which of the following statements about the undescended testis is the most accurate?

• A. Normally, the testes descend by one year of age.
• B. The infant will likely require surgical intervention.
• C. The infant likely has only one testis.
• D. Normally, the testes are descended by birth.

Correct answer: A

Rationale: The correct answer is that normally, the testes descend by one year of age. In young infants, it is common for the testes to retract into the inguinal canal when the environment is cold or the cremasteric reflex is stimulated. The exam should be done in a warm room with warm hands. It is most likely that both testes are present and will descend by a year. Option B is incorrect as not all cases of undescended testes require surgical intervention. Option C is incorrect because feeling only one testis does not necessarily mean the infant only has one testis. Option D is inaccurate as the testes do not normally descend by birth, but rather by one year of age. If the testes do not descend by one year, a full assessment will be needed to determine the appropriate treatment.

5. What is the expected date of delivery for your pregnant client when her last menstrual period was on 10/20/2016

• A. 7/7/2017
• B. 8/7/2017
• C. 6/7/2017
• D. 8/1/2017

Correct answer: A

Rationale: The expected date of delivery is calculated using Nagle's rule which is: The first day of last menstrual period - 3 months + 7 days = the estimated date of delivery

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