Nursing Elites

1. Where will the nurse collect the most reliable source of pain assessment?

• A. From the nurse-to-nurse bedside report
• B. From a medical surgical book
• C. From the client
• D. From the client's chart

Correct answer: C

Rationale:

2. What is an infectious disease that can be transmitted directly from one person to another?

• A. A communicable disease
• B. A portal of exit from the reservoir
• C. A susceptible host
• D. A portal of entry to a host

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. The client asks the nurse what nonpharmacological intervention can be used to reduce pain and swelling in her joints affected by rheumatoid arthritis. What is the most appropriate response by the nurse?

• A. "Ice packs can be used to reduce swelling but should be removed after 20 minutes."?
• B. "Heat always makes the swelling go down. You do not need any other interventions."?
• C. "Try high impact exercise exercise like running to loosen up your joints and reduce pain."?
• D. "Apply ice packs. It is generally okay to keep them on for up to one hour at a time."?

Correct answer: A

Rationale:

5. The medical record for a client states that the client has hemiplegia. What does this mean?

• A. The client can use his right arm, left leg, and left arm.
• B. The client has paralysis of all four extremities.
• C. The client has decreased vision in one eye.
• D. The client has paralysis on one side of the body.

Correct answer: D

Rationale: Hemiplegia refers to paralysis on one side of the body, affecting either the right or left side. Choice A is incorrect because it describes selective paralysis of specific limbs, not one side of the body. Choice B is incorrect as hemiplegia does not involve paralysis of all four extremities. Choice C is also incorrect as decreased vision in one eye is not indicative of hemiplegia.

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