Nursing Elites

1. The nurse is evaluating the growth and development of a toddler with AIDS. The nurse would anticipate finding that the child has

• A. Achieved developmental milestones at an erratic rate
• B. Delay in musculoskeletal development
• C. Displayed difficulty with speech development
• D. Delay in achievement of most developmental milestones

Correct answer: D

Rationale: Children with AIDS often experience delays in achieving developmental milestones, affecting their overall growth and development. This delay can impact various areas of development, not limited to a specific aspect like musculoskeletal or speech development. While some children may achieve milestones at varying rates (choice A), the general trend is a delay in multiple milestones (choice D). Musculoskeletal development (choice B) and speech development (choice C) may be affected but are not as comprehensive as the delay in most developmental milestones.

2. An 82-year-old client is prescribed eye drops for the treatment of glaucoma. What assessment is needed before the nurse begins teaching proper administration of the medication?

• A. Determine the client's manual dexterity
• B. The client’s manual dexterity
• C. Proximity to health care services
• D. Ability to use visual assistive devices

Correct answer: B

Rationale: Assessing the client’s manual dexterity is crucial before teaching the administration of eye drops. Manual dexterity is essential for the proper instillation of eye drops. If the client has limited manual dexterity, alternative methods of administration may be necessary. The other choices, such as determining third-party payment plan, proximity to health care services, and ability to use visual assistive devices, are not directly related to the immediate need for assessing manual dexterity for the proper administration of eye drops.

3. In planning the use of resources for secondary prevention in a community clinic serving migrant families, which activity should be the priority?

• A. Skin testing for tuberculosis.
• B. Glucose monitoring for diabetes.
• C. Blood work for cardiovascular disease.
• D. Height and weight for altered nutrition.

Correct answer: A

Rationale: The correct answer is A: Skin testing for tuberculosis. In a community clinic serving migrant families, tuberculosis is a significant health concern due to close living conditions and potential exposure during migration. Skin testing for tuberculosis is crucial for secondary prevention as it helps in early detection and prevention of the spread of the disease within the community. Choices B, C, and D are important health screenings but may not be the priority in this specific population where tuberculosis poses a higher risk.

4. The nurse is teaching a group of older adults about medication safety. Which of the following should be included in the teaching?

• A. keeping a list of all medications and dosages
• B. sharing medications with family members if they have the same prescription
• C. stopping medications when symptoms improve
• D. doubling up on missed doses

Correct answer: A

Rationale: The correct answer is A: keeping a list of all medications and dosages. Maintaining a comprehensive list of medications and their dosages is essential for older adults to prevent medication errors and dangerous interactions. Choice B is incorrect because sharing medications, even if family members have the same prescription, can lead to unintended adverse effects or inappropriate dosages. Choice C is incorrect as stopping medications when symptoms improve can be harmful if the full course of treatment is not completed. Choice D is incorrect as doubling up on missed doses can result in overdosing and adverse reactions.

5. As a client who is terminally ill has been receiving high doses of an opioid analgesic for the past month and becomes unresponsive to verbal stimuli as death approaches, what orders would the nurse expect from the healthcare provider?

• A. Decrease the analgesic dosage by half
• B. Discontinue the analgesic
• C. Continue the same analgesic dosage
• D. Prescribe a less potent drug

Correct answer: C

Rationale: Continuing the same dosage of analgesic is appropriate to manage pain effectively as death nears and the client becomes unresponsive. The primary goal of palliative care in end-of-life situations is to ensure comfort, regardless of the client's level of consciousness. Decreasing the analgesic dosage or discontinuing it could lead to inadequate pain relief, which goes against the principles of palliative care. Prescribing a less potent drug may also compromise pain management in this critical stage. Therefore, maintaining the same analgesic dosage is the most appropriate action to provide comfort and alleviate suffering.

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