Nursing Elites

1. 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.

2. A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?

• A. A 17-year-old who is sexually active with numerous partners.
• B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
• C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
• D. A 34-year-old male homosexual who is in a monogamous relationship.

Correct answer: A

Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.

3. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse should monitor the client for which of the following side effects?

• A. Constipation
• B. Hypertension
• C. Muscle weakness
• D. Bradycardia

Correct answer: D

Rationale: The correct answer is D: Bradycardia. Pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis, can lead to bradycardia as a side effect. Choice A, constipation, is not a common side effect of pyridostigmine. Choice B, hypertension, is unlikely as pyridostigmine is more likely to cause hypotension. Choice C, muscle weakness, is actually a symptom of myasthenia gravis itself and not a side effect of pyridostigmine.

4. Which of the following is an example of a social determinant of health?

• A. Blood pressure
• B. Genetic mutations
• C. Housing conditions
• D. Age

Correct answer: C

Rationale: The correct answer is C: Housing conditions. Social determinants of health are the conditions in which people are born, grow, live, work, and age. Housing conditions directly impact health outcomes as they can affect exposure to toxins, safety, and overall well-being. Choice A, blood pressure, is a physiological measure and not a social determinant. Choice B, genetic mutations, relates to an individual's genetic makeup and is not influenced by social factors. Choice D, age, is a demographic factor and not a social determinant of health.

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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