Nursing Elites

1. Which of the following conditions most commonly causes acute glomerulonephritis?

• A. A congenital condition leading to renal dysfunction.
• B. Prior infection with group A Streptococcus within the past 10-14 days.
• C. Viral infection of the glomeruli.
• D. Nephrotic syndrome.

Correct answer: B

Rationale: Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis.

2. The nurse provides discharge instructions to a patient who was hospitalized for pneumonia. Which statement, if made by the patient, indicates a good understanding of the instructions?

• A. I will call the doctor if I still feel tired after a week.
• B. I will continue to do the deep breathing and coughing exercises at home.
• C. I will continue to do the deep breathing and coughing exercises at home.
• D. I'll cancel my chest x-ray appointment if Im feeling better in a couple weeks

Correct answer: C

Rationale: Patients should continue to cough and deep breathe after discharge. Fatigue is expected for several weeks. The Pneumovax and influenza vaccines can be given at the same time in different arms. Explain that a follow-up chest x-ray needs to be done in 6 to 8 weeks to evaluate resolution of pneumonia.

3. To palpate the liver during a head-to-toe physical assessment, the nurse should

• A. put pressure on the biopsy site using a sandbag
• B. elevate the head of the bed to facilitate breathing
• C. place the patient on the right side with the bed flat
• D. check the patient's post-biopsy coagulation studies

Correct answer: C

Rationale: To palpate the liver effectively during a head-to-toe physical assessment, the patient should be positioned on the right side with the bed flat. This position helps to splint the biopsy site and allows for proper palpation of the liver. Elevating the head of the bed has no direct relevance to palpating the liver. Checking coagulation studies is done before the biopsy and is unrelated to palpation. Putting pressure on the biopsy site using a sandbag is not an appropriate way to facilitate liver palpation as it does not provide the necessary support and stabilization needed for the procedure.

4. The nurse is performing tuberculosis (TB) skin tests in a clinic that has many patients who have immigrated to the United States. Which question is most important for the nurse to ask before the skin test?

• A. Is there any family history of TB?
• B. How long have you lived in the United States?
• C. Do you take any over-the-counter (OTC) medications?
• D. Have you received the bacille Calmette-Guerin (BCG) vaccine for TB?

Correct answer: D

Rationale: It is crucial for the nurse to inquire about whether the patient has received the bacille Calmette-Guerin (BCG) vaccine for TB before performing the skin test. Patients who have received the BCG vaccine can have a positive Mantoux test, leading to the need for alternative screening methods, such as a chest x-ray, to determine TB infection. While family history of TB and length of time in the United States are relevant factors, they do not directly impact the decision to perform the TB skin test. Asking about over-the-counter medications, unless relevant to TB treatment, is not as critical as assessing BCG vaccination status.

5. Which of the following complaints is characteristic of a patient with Bell's Palsy?

• A. Paralysis of the right or left arm
• B. Malfunction of a certain cranial nerve
• C. A sub-condition of Cerebral Palsy
• D. A side effect of a stroke

Correct answer: B

Rationale: Bell's Palsy is characterized by the dysfunction of the Facial nerve, which is cranial nerve VII. This dysfunction leads to facial muscle weakness or paralysis, not affecting the arms. Choice A is incorrect as Bell's Palsy specifically involves facial muscles, not the arms. Choice C is incorrect as it incorrectly associates Bell's Palsy with a different condition, Cerebral Palsy. Choice D is incorrect as Bell's Palsy is not a side effect of a stroke but rather a distinct condition with its own etiology.

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