Nursing Elites

1. Which of the following abides by the Americans with Disabilities Act of 1990?

• A. A nurse manager cannot cancel an interview with a potential employee because he has left-sided paralysis
• B. A nurse is allowed to have a leave of absence to recover after a back injury
• C. A nurse is mandated to receive 12 weeks off of work after having a baby
• D. A nurse manager must hire a nurse who uses a walker for mobility

Correct answer: A

Rationale: The Americans with Disabilities Act of 1990 prohibits discrimination against individuals with disabilities in employment practices, ensuring equal opportunities for qualified individuals. Therefore, a nurse manager cannot cancel an interview with a potential employee simply because the individual has left-sided paralysis. Doing so would be considered discriminatory under the ADA. Choices B, C, and D do not directly align with ADA requirements. Choice B involves medical leave, which can be covered under a different law; choice C refers to maternity leave, which is protected under other regulations; and choice D involves a hiring decision based on a mobility aid, not the individual's qualifications, which does not fall under ADA guidelines.

2. A client is seen in the emergency room as a victim of suspected domestic violence. The nurse's aide brings the client to a center curtained area, gives her a gown to change into, and asks her to wait for the nurse. What is the most appropriate action of the nurse upon arrival?

• A. Ask the client to undress to assess for injuries
• B. Take the client into a private room
• C. Notify the police to file a report
• D. Notify the house supervisor to keep security on alert

Correct answer: B

Rationale: When dealing with a client suspected of domestic violence, it is crucial to provide privacy and a safe environment. Taking the client into a private room allows for a confidential conversation and assessment without compromising the client's safety or dignity. The nurse should prioritize creating a safe space for the client to share information and receive support. Notification of authorities should only occur once a thorough assessment has been conducted to ensure the client's safety and well-being. Option A is incorrect because asking the client to undress should be done with sensitivity and respect for the client's privacy, focusing on assessing injuries rather than visualizing them. Option C is premature as involving the police should be based on a comprehensive assessment and the client's consent. Option D is not the most immediate and direct action required to address the client's immediate needs in a suspected domestic violence situation.

3. What consideration is important when caring for a female Muslim patient?

• A. Make eye contact
• B. Provide long-sleeved gowns or allow her to use her own
• C. Touch while talking
• D. Assign male caregivers when possible

Correct answer: B

Rationale: When caring for a female Muslim patient, providing long-sleeved gowns or allowing her to use her own clothing is crucial. Most Muslim women prefer to cover their whole body, even during examinations. Offering long gowns with long sleeves or allowing the patient to use her own clothing respects her cultural and religious preferences. Making eye contact is not a common practice in some Muslim cultures, so it's important to be mindful of this and respect the patient's preferences. Touching while talking may not be culturally appropriate for some Muslim patients, so it's best to avoid it unless necessary. Assigning female caregivers is often preferred to respect the patient's modesty and religious beliefs. If a male caregiver or physician needs to interact with the patient, the patient's husband may request to be present in the room.

4. The client is receiving discharge teaching seven (7) days post myocardial infarction and inquires why he must wait six (6) weeks before engaging in sexual intercourse. What is the best response by the nurse to this question?

• A. "You need to regain your strength before attempting such exertion."?
• B. "When you can climb 2 flights of stairs without problems, it is generally safe."?
• C. "Have a glass of wine to relax you, then you can try to have sex."?
• D. "If you can maintain an active walking program, you will have less risk."?

Correct answer: B

Rationale: Following a myocardial infarction, there is a risk of cardiac rupture at the site of the infarction for approximately six (6) weeks until scar tissue forms. The advice to wait until the client can climb two flights of stairs without issues is common among healthcare providers as it indicates an adequate level of physical exertion tolerance and suggests a lower risk of complications during sexual activity. Choice A is not specific to the recovery timeline related to sexual activity post-myocardial infarction. Choice C is inappropriate as alcohol consumption should not be recommended before sexual activity. Choice D, though promoting an active lifestyle, does not directly address the safety concerns related to sexual intercourse post-myocardial infarction.

5. A nonimmunized child appears at the clinic with a visible rash. Which of the following observations indicates the child may have rubeola (measles)?

• A. Small blue-white spots are visible on the oral mucosa.
• B. The rash begins on the trunk and spreads outward.
• C. There is low-grade fever.
• D. The lesions have a "teardrop-on-a-rose-petal"? appearance.

Correct answer: A

Rationale: The presence of small blue-white spots on the oral mucosa, known as Koplik's spots, is characteristic of measles (rubeola) infection. These spots typically appear on the buccal mucosa opposite the second molars, 1-2 days before the rash onset, and last until 2 days after the rash appears. While Koplik's spots are pathognomonic for measles, their absence does not rule out the diagnosis. Therefore, choice A is the correct answer. Choices B, C, and D are incorrect because the rash pattern, presence of low-grade fever, and characteristic appearance of lesions are not specific indicators of measles infection.

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