Nursing Elites

1. When assessing a client with suspected meningitis, which finding is indicative of meningeal irritation?

• A. Brudzinski's sign
• B. Positive Babinski reflex
• C. Kernig's sign
• D. Both A and C

Correct answer: D

Rationale: Both Brudzinski's sign and Kernig's sign are classic signs of meningeal irritation, commonly associated with meningitis. Brudzinski's sign is positive when flexing the neck causes involuntary flexion of the hips and knees due to irritation of the meninges. Kernig's sign is positive when there is pain and resistance with knee extension after hip flexion, indicating meningeal irritation or inflammation. The Babinski reflex, mentioned in choice B, is a test used to assess upper motor neuron damage and is not specific to meningitis. Therefore, choices A and C are the correct options as they are indicative of meningeal irritation in a suspected case of meningitis.

2. The nurse has completed the admission assessment of a client and has determined that the client's body mass index (BMI) is 33.5 kg/m2. What health promotion advice should the nurse provide to the client?

• A. It would be very helpful if you could integrate more physical activity into your routine.
• B. You're considered to be overweight, so you should be diligent about maintaining a healthy diet.
• C. You might want to consider some of the surgical options that have been developed for treating obesity.
• D. With your permission, I'd like you to refer to a support group for individuals who live with severe obesity.

Correct answer: A

Rationale: Increasing physical activity is a key component of managing BMI and overall health.

3. A client who has Type 1 diabetes and is at 10-weeks gestation comes to the prenatal clinic complaining of a headache, nausea, sweating, feeling shaky, and being tired all the time. What action should the nurse take first?

• A. Check the blood glucose level.
• B. Draw blood for a Hemoglobin A1C.
• C. Assess urine for ketone levels.
• D. Provide the client with a protein snack.

Correct answer: A

Rationale: The correct action for the nurse to take first is to check the client's blood glucose level. This is crucial to determine if the symptoms are a result of hypoglycemia or hyperglycemia, which requires immediate attention to maintain the client's health and the health of the developing fetus.

4. A client with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction should the nurse provide?

• A. Take the medication with a meal.
• B. Take the medication at bedtime.
• C. Take the medication on an empty stomach.
• D. Take the medication with an antacid.

Correct answer: C

Rationale: The correct instruction for a client prescribed levothyroxine (Synthroid) is to take the medication on an empty stomach. This ensures optimal absorption of levothyroxine. Taking it with a meal can interfere with absorption due to food interactions. Taking it at bedtime may lead to inconsistent absorption as it should be taken at the same time every day in the morning. Taking it with an antacid can reduce the absorption of levothyroxine, making it less effective.

5. A 40-year-old woman presents with a history of chronic constipation, bloating, and abdominal pain. She notes that the pain is relieved with defecation. She denies any weight loss, blood in her stools, or nocturnal symptoms. Physical examination and routine blood tests are normal. What is the most likely diagnosis?

• A. Inflammatory bowel disease
• B. Irritable bowel syndrome
• C. Celiac disease
• D. Lactose intolerance

Correct answer: B

Rationale: The patient's symptoms of chronic constipation, bloating, abdominal pain relieved with defecation, absence of weight loss, blood in stools, or nocturnal symptoms, along with normal physical examination and routine blood tests, are indicative of irritable bowel syndrome (IBS). IBS is a functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of any organic cause. It is a diagnosis of exclusion made based on symptom criteria, and the provided clinical scenario aligns with the typical presentation of IBS.

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