Nursing Elites

1. When teaching a group of school-aged children how to reduce the risk for Lyme disease, which instruction should the camp nurse include?

• A. Wash hands frequently.
• B. Avoid drinking lake water.
• C. Do not share personal products.
• D. Wear long sleeves and pants.

Correct answer: D

Rationale: The correct answer is 'Wear long sleeves and pants.' This instruction is crucial in reducing the risk of Lyme disease because it helps minimize exposure to ticks that carry the disease. Ticks are commonly found in grassy and wooded areas, so covering up with long sleeves and pants can act as a physical barrier and prevent ticks from attaching to the skin. Choices A, B, and C are not directly related to preventing Lyme disease. Washing hands frequently is important for general hygiene but not specifically for preventing tick bites. Avoiding drinking lake water is more about preventing waterborne illnesses rather than Lyme disease. Not sharing personal products is important for preventing the spread of infections but is not directly related to Lyme disease prevention.

2. The nurse is caring for a client with a diagnosis of major depressive disorder who has been prescribed a selective serotonin reuptake inhibitor (SSRI). What is the most important teaching point?

• A. Take the medication with food.
• B. Expect to see improvement within 24 hours.
• C. Avoid drinking grapefruit juice.
• D. Report any thoughts of self-harm immediately.

Correct answer: D

Rationale: The correct answer is D: 'Report any thoughts of self-harm immediately.' Clients prescribed SSRIs should be educated to report any thoughts of self-harm promptly, as these medications can initially increase suicidal ideation. Choice A is incorrect because SSRIs are usually taken on an empty stomach. Choice B is incorrect as it takes several weeks for SSRIs to reach their full effectiveness. Choice C is irrelevant to SSRI therapy.

3. Before a client undergoes a Magnetic Resonance Imaging (MRI) scan with contrast, what should the nurse assess?

• A. If the client has any metal implants
• B. If the client has allergies to iodine or shellfish
• C. If the client has a history of claustrophobia
• D. If the client has ever had a similar procedure before

Correct answer: A

Rationale: Before an MRI scan with contrast, the nurse should assess if the client has any metal implants. Metal implants can interfere with the magnetic field of the MRI, which can pose a risk to the client's safety and compromise the quality of the scan. Assessing for allergies to iodine or shellfish (Choice B) is important for contrast agents but not specific to metal implants. Claustrophobia assessment (Choice C) is relevant for MRI scans due to the confined space but not specific to metal implants. Past procedures (Choice D) are important for comparison but not directly related to the risks associated with metal implants during an MRI scan with contrast.

4. A client with chronic kidney disease is receiving hemodialysis. Which assessment finding should the nurse report to the healthcare provider immediately?

• A. Decreased urine output
• B. Weight loss of 1 kg
• C. Blood pressure of 150/90 mm Hg
• D. Presence of a bruit over the fistula

Correct answer: C

Rationale: The correct answer is C. An elevated blood pressure in clients with chronic kidney disease undergoing hemodialysis can indicate fluid overload or poor dialysis efficacy and should be reported immediately. This finding could lead to complications such as heart failure or pulmonary edema. Choices A, B, and D are not as critical in this situation. Decreased urine output may be expected due to the kidney disease, a weight loss of 1 kg is within an acceptable range, and the presence of a bruit over the fistula is a common finding in clients undergoing hemodialysis and does not require immediate reporting.

5. The client is being educated by the nurse about the side effects of prednisone. Which side effect should the client be instructed to report immediately?

• A. Weight gain.
• B. Increased appetite.
• C. Hyperglycemia.
• D. Fever or sore throat.

Correct answer: D

Rationale: The correct answer is D: Fever or sore throat. These symptoms should be reported immediately as they could indicate an infection, which can be serious in clients taking prednisone due to its immunosuppressive effects. Choices A and B are common side effects of prednisone but are not typically considered urgent. Choice C, hyperglycemia, is a known side effect of prednisone but is not an immediate concern compared to the potential of an infection signaled by fever or sore throat.

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