Nursing Elites

1. The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to:

• A. Reports of difficulty falling and staying asleep
• B. Expression of persistent suicidal thoughts
• C. Lack of enjoyment in usual pleasures
• D. Reduced senses of taste and smell

Correct answer: C

Rationale: The correct answer is C: Lack of enjoyment in usual pleasures. Anhedonia is the inability to feel pleasure in normally pleasurable activities. Choice A, reports of difficulty falling and staying asleep, is more indicative of insomnia rather than anhedonia. Choice B, expression of persistent suicidal thoughts, is related to suicidal ideation and not anhedonia. Choice D, reduced senses of taste and smell, is more associated with disturbances in the sense of taste and smell, not anhedonia.

2. What influences health status?

• A. lifestyle choices and community resources
• B. availability of health technology like diagnostic machines
• C. presence of toxic environmental conditions
• D. all of the above

Correct answer: D

Rationale: Health status is influenced by a combination of lifestyle choices, community resources, health technology like diagnostic machines, and environmental conditions. Each of these factors plays a role in determining an individual's overall health. Choice A is correct as lifestyle choices (such as diet, exercise, and smoking habits) and access to community resources (like healthcare facilities, support groups, and recreational spaces) are important determinants of health. Choice B is correct as the availability of health technology, including diagnostic machines, can impact early detection and treatment of health conditions. Choice C is correct as exposure to toxic environmental conditions (such as pollution, contaminated water, or hazardous waste) can have adverse effects on health. Therefore, the correct answer is D because all of these factors collectively influence health status.

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. When caring for premature newborns in an intensive care setting, a nurse carefully monitors oxygen concentration. What is the most common complication of this therapy?

• A. Intraventricular hemorrhage
• B. Retinopathy of prematurity
• C. Bronchopulmonary dysplasia
• D. Necrotizing enterocolitis

Correct answer: B

Rationale: Retinopathy of prematurity is the most common complication in premature infants exposed to high concentrations of oxygen. This condition leads to abnormal blood vessel growth in the retina, which can potentially result in blindness if not managed promptly. Intraventricular hemorrhage, though a significant concern in premature infants, is not directly related to oxygen therapy. Bronchopulmonary dysplasia is primarily associated with mechanical ventilation and oxygen exposure over time, not specifically with oxygen concentration monitoring. Necrotizing enterocolitis is more linked to gastrointestinal issues and is not the most common complication of oxygen therapy in premature newborns.

5. When a nurse teaches a community about the importance of hand hygiene, the nurse is engaging in:

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

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention aims to prevent the occurrence of a disease or injury before it happens. Teaching about hand hygiene to the community helps in preventing infections from occurring in the first place. Choice B, Secondary prevention, involves early detection and treatment to halt or slow the progress of a condition. This would involve screening or early intervention after exposure. Choice C, Tertiary prevention, focuses on managing the disease to prevent complications, recurrence, or deterioration. This would include rehabilitation and monitoring to prevent further complications. Choice D, Quaternary prevention, relates to actions taken to avoid unnecessary interventions or over-medicalization. This usually involves questioning the necessity of certain medical procedures or treatments to prevent harm to patients.

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