Nursing Elites

1. What are signs of hearing loss? (Select all that apply)

• A. Answering questions correctly
• B. Presence of cerumen
• C. Tinnitus
• D. Frequent asking of others to repeat statements

Correct answer: C

Rationale: Signs of hearing loss include tinnitus, frequent asking to repeat statements, and shouting in conversations.

2. A nurse is providing teaching to an older client who has osteoarthritis that is affecting the knees. What statement by the client indicates a correct understanding of the teaching?

• A. I can use either heat or ice to help relieve the discomfort
• B. The purpose of drug therapy is to stop the disease progression.'
• C. I will start a daily running program to get more exercise.'
• D. I should avoid physical activity to prevent further injury.'

Correct answer: A

Rationale:

3. A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?

• A. Once retinal detachment occurs, it does not return to its normal state
• B. Once the tissue has necrosed from high-pressure, it does not regenerate
• C. Glaucoma always leads to permanent blindness
• D. Once bacterial infection has caused damage, the tissue does not regenerate

Correct answer: B

Rationale: The correct explanation for irreversible vision loss in glaucoma is that once the tissue has necrosed from high pressure, it does not regenerate. This necrosis occurs due to the damage caused by increased intraocular pressure, which leads to irreversible damage to the optic nerve and retinal tissue. Choices A, C, and D are incorrect because they do not directly address the specific mechanism of irreversible vision loss in glaucoma, which is necrosis due to high pressure.

4. A nurse is teaching a client who has out about dietary recommendations. The nurse should teach the client which of the following beverages can trigger an attack?

• A. Fruit juice
• B. Alcohol
• C. Milk
• D. Coffee

Correct answer: B

Rationale:

5. A client is immobile and requires mechanical ventilation with a tracheostomy. She has a pressure injury on her coccyx measuring 5 cm by 3 cm. the nurse observes bone and tendon at the base of the wound. How would the nurse document this wound?

• A. Stage III pressure injury
• B. A stage II pressure injury
• C. A non-staging pressure injury
• D. Stage IV pressure injury

Correct answer: D

Rationale:

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