Nursing Elites

1. The nurse is assigned to a client with Parkinson's disease. Which findings would the nurse anticipate?

• A. Non-intention tremors and urgency with voiding
• B. Echolalia and a shuffling gait
• C. Muscle spasm and a bent-over posture
• D. Intention tremor and jerky movement of the elbows

Correct answer: B

Rationale: The correct answer is B. Echolalia (repeating others' words) and a shuffling gait are common symptoms of Parkinson's disease. These symptoms result from the degeneration of the basal ganglia in the brain that controls movement and speech. Choice A is incorrect because non-intention tremors are not typically associated with Parkinson's disease. Choice C is incorrect as muscle spasm and a bent-over posture are not classic manifestations of Parkinson's disease. Choice D is incorrect since intention tremors and jerky movement of the elbows are not characteristic of Parkinson's disease.

2. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most important for the nurse to make?

• A. Pastoral care.
• B. Meals-on-Wheels.
• C. Grief support group.
• D. Physical therapy.

Correct answer: B

Rationale: The most important referral for the nurse to make for the elderly, recently widowed female client who had a mild stroke and limited mobility is Meals-on-Wheels. This service will ensure she receives proper nutrition and support given her circumstances. Pastoral care may provide emotional and spiritual support but is not as essential in this scenario. Grief support group could be beneficial but addressing her nutritional needs takes precedence. Physical therapy may be important for rehabilitation but ensuring proper nutrition is more critical at this time.

3. A senior high school student, whose immunization status is current, asks the school nurse which immunizations will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive?

• A. Hepatitis C (HepC)
• B. Influenza type B (HIB)
• C. Measles, mumps, rubella (MMR)
• D. Diphtheria, tetanus, pertussis (DTaP)

Correct answer: C

Rationale: The correct answer is C: Measles, mumps, rubella (MMR). MMR vaccine is commonly included in precollege physicals to ensure students are protected against these diseases. Choice A, Hepatitis C (HepC), is incorrect as the standard vaccine for hepatitis given in childhood is Hepatitis B. Choice B, Influenza type B (HIB), is not typically administered during precollege physicals but is recommended for younger children. Choice D, Diphtheria, tetanus, pertussis (DTaP), is usually given in early childhood and not typically repeated during precollege physicals.

4. The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing?

• A. Primary prevention.
• B. Tertiary prevention.
• C. Secondary prevention.
• D. Primary nursing.

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Administering a booster dose of DTaP vaccine to an infant is an example of primary prevention. Primary prevention aims to prevent disease or injury before it occurs by preventing exposure to risk factors. Tertiary prevention focuses on reducing the impact of a disease or injury that has already occurred, while secondary prevention involves early detection and treatment to prevent the progression of disease. Choice B, tertiary prevention, is incorrect as it deals with managing the consequences of a disease rather than preventing it. Choice C, secondary prevention, is also incorrect as it focuses on early detection and treatment rather than vaccination to prevent the disease. Choice D, primary nursing, is unrelated to the level of prevention being implemented in this scenario.

5. Which of the following measures the frequency of new cases of the phenomenon during a given period of time?

• A. prevalence rate
• B. proportionate mortality rate
• C. case fatality rate
• D. incidence rate

Correct answer: D

Rationale: The correct answer is D, incidence rate. Incidence rate measures the frequency of new cases of a phenomenon, providing important information about the risk of developing the condition. Prevalence rate (choice A) reflects both old and new cases, proportionate mortality rate (choice B) is the proportion of deaths due to a specific cause, and case fatality rate (choice C) measures the proportion of deaths among confirmed cases, not just new cases.

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