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. The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse or a practical nurse?

• A. assessment of the speech pattern of a mobile adult who had a mild stroke last year
• B. safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting
• C. wound care for a client who had postoperative infection following abdominal surgery two weeks ago
• D. evaluation of crutch use by a 65-year-old client who broke his tibia while snow skiing

Correct answer: C

Rationale: The correct answer is C because wound care for a postoperative infection qualifies for Medicare reimbursement. Medicare typically covers skilled nursing care, like wound care, required due to a postoperative infection. Choices A, B, and D involve assessments, teaching, and evaluation, which may not always be eligible for Medicare reimbursement unless they are directly related to skilled nursing care for a specific medical condition.

3. What is the focus of health promotion activities?

• A. Treating existing health conditions
• B. Preventing the onset of disease
• C. Providing palliative care
• D. Conducting clinical trials

Correct answer: B

Rationale: The correct answer is B: Preventing the onset of disease. Health promotion activities aim to prevent illnesses and promote overall well-being through education, lifestyle changes, and preventive measures. Choice A is incorrect as health promotion is not primarily about treating existing health conditions but rather preventing them. Choice C is incorrect because palliative care focuses on providing relief and comfort to patients with serious illnesses, not on preventing diseases. Choice D is also incorrect as conducting clinical trials is a research activity to test new treatments or interventions, not a focus of health promotion.

4. Statistics of illnesses are termed as:

• A. Vital statistics
• B. Morbidity
• C. Statistics
• D. Mortality

Correct answer: B

Rationale: The correct answer is B: 'Morbidity.' Morbidity specifically refers to the statistics of illnesses, encompassing the incidence, prevalence, and duration of disease within a population. Choice A, 'Vital statistics,' typically refers to data on births, deaths, marriages, and divorces. Choice C, 'Statistics,' is a broad term encompassing the collection, analysis, interpretation, and presentation of numerical data. Choice D, 'Mortality,' specifically refers to the state of being subject to death or the number of deaths in a given population.

5. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

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