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 occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?

• A. Contributes money to a professional society or organization
• B. Maintains chairmanship of the hospital nursing council
• C. Documents the nursing process in care management
• D. Develops policy initiatives that impact occupational health and safety

Correct answer: B

Rationale: Maintaining chairmanship of the hospital nursing council demonstrates leadership and professionalism. This role involves overseeing and leading nursing activities at the hospital, showcasing a high level of responsibility and professionalism. Choices A, C, and D do not directly relate to demonstrating professionalism. Contributing money to a professional society, documenting the nursing process, or developing policy initiatives, while valuable activities, do not directly reflect the same level of leadership and professionalism as maintaining chairmanship.

3. A client was admitted with a diagnosis of pneumonia. When auscultating the client's breath sounds, the nurse hears inspiratory crackles in the right base. Temperature is 102.3 degrees Fahrenheit orally. What finding would the nurse expect?

• A. Flushed skin
• B. Bradycardia
• C. Mental confusion
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C: Mental confusion. In this scenario, the client's high fever and pneumonia diagnosis indicate an infection. Infections, especially in older adults, can lead to mental confusion due to the body's systemic response to the infection. Flushed skin (choice A) is more commonly associated with fever but does not specifically relate to the client's condition. Bradycardia (choice B) and hypotension (choice D) are less likely findings in a client with pneumonia and a high fever; instead, tachycardia and increased blood pressure are more commonly seen in response to infection.

4. A client is scheduled to have a blood test for cholesterol and triglycerides the next day. The nurse would tell the client

• A. ''Be sure to eat a fat-free diet until the test.''
• B. ''Do not eat or drink anything but water for 12 hours before the blood test.''
• C. ''Have the blood drawn within 2 hours of eating breakfast.''
• D. ''Stay at the laboratory so 2 blood samples can be drawn an hour apart.''

Correct answer: B

Rationale: Fasting for at least 12 hours is necessary before a cholesterol and triglyceride test to ensure accurate results by avoiding fluctuations that can occur after eating. Choice A is incorrect because a fat-free diet is not required; fasting is. Choice C is incorrect as it suggests having the test right after eating, which can affect the results. Choice D is incorrect as there is no need to stay at the laboratory for 2 blood samples unless specifically instructed by a healthcare provider.

5. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

• A. A male with a serum cholesterol level of 199 mg/dl.
• B. A female with a serum cholesterol level of 201 mg/dl.
• C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.
• D. A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

Correct answer: C

Rationale: The correct answer is C. A male with a high LDL level (200 mg/dl) has a significant risk for cardiovascular disease. High levels of LDL cholesterol are associated with an increased risk of atherosclerosis and heart disease. Choices A, B, and D have serum cholesterol levels that are slightly elevated but are not as specific or directly linked to cardiovascular risk as high LDL levels. Therefore, the client with the high LDL level is at the greatest risk for cardiovascular disease.

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