Nursing Elites

1. Which of the following diseases or disorders is acute?

• A. Pneumonia
• B. Paralysis
• C. Alzheimer's disease
• D. Diabetes

Correct answer: A

Rationale: The correct answer is Pneumonia. Pneumonia is an acute illness characterized by inflammation of the air sacs in the lungs. It comes on suddenly and typically lasts for a short duration. Treatment can help cure pneumonia. Paralysis, Alzheimer's disease, and Diabetes are chronic conditions. Paralysis is the loss of muscle function in part of the body, usually permanent. Alzheimer's disease is a progressive brain disorder leading to memory loss and cognitive decline, and it is incurable. Diabetes is a chronic condition that affects how your body turns food into energy, and it requires lifelong management. Therefore, Pneumonia is the only acute condition among the options provided.

2. When administering a-interferon and ribavirin (Rebetol) to a patient with chronic hepatitis C, the nurse should monitor for which complication?

• A. Leukopenia.
• B. Hypokalemia.
• C. Polycythemia.
• D. Hypoglycemia.

Correct answer: B

Rationale: When administering a-interferon and ribavirin (Rebetol) for chronic hepatitis C, the nurse should monitor for hypokalemia. This combination therapy is known to cause leukopenia, not polycythemia or hypoglycemia. Hypokalemia is a common electrolyte imbalance that can occur with these medications, making it the correct answer to monitor for in this case.

3. A client in the ICU has been intubated and placed on a ventilator. The physician orders synchronous intermittent mandatory ventilation (SIMV). Which statement best describes the work of this mode of ventilation?

• A. The ventilator delivers a set rate and tidal volume regardless of whether the client is attempting to breathe
• B. The ventilator coordinates delivered breaths with the client's respiratory efforts
• C. The ventilator provides a supplemental breath for every third breath of the client
• D. The ventilator provides breaths during the expiratory phase of the client's respirations

Correct answer: B

Rationale: Synchronous intermittent mandatory ventilation (SIMV) is a ventilation mode that coordinates delivered breaths with the client's own respiratory efforts. This mode allows the client to initiate breaths, with the ventilator providing preset breaths at a controlled rate and volume. Option A is incorrect because in SIMV, the ventilator syncs with the client's respiratory efforts. Option C is incorrect as it does not accurately depict the way SIMV works. Option D is also incorrect as SIMV does not specifically provide breaths during the expiratory phase of the client's respirations. Therefore, the correct answer is B, where the ventilator coordinates breath delivery with the client's breathing efforts.

4. After assessing Mr. B, what is the initial action of the nurse?

• A. Immediately place the client in a negative-pressure room
• B. Set the client up to receive a bronchoscopy
• C. Contact the physician for antifungal medications
• D. Administer oxygen and assist the client to sit in the semi-Fowler's position

Correct answer: A

Rationale: The first action the nurse should take after assessing Mr. B is to administer oxygen and assist him to sit in the semi-Fowler's position. Administering oxygen helps improve tissue oxygenation, while sitting up in a semi-Fowler's position aids in better breathing and secretion clearance. Placing the client in a negative-pressure room is not the immediate priority unless isolation is needed. Performing a bronchoscopy or contacting the physician for antifungal medications is not the initial step in managing a client with suspected pneumonia.

5. Which playroom activities should the nurse organize for a small group of 7-year-old hospitalized children?

• A. Sports and games with rules
• B. Finger paints and water play
• C. Dress-up clothes and props
• D. Chess and television programs

Correct answer: A

Rationale: The correct answer is 'Sports and games with rules.' For 7-year-old children, organized activities that involve rules are beneficial as they promote cooperation, logical reasoning, and the development of social skills. Sports and games with rules help children understand the importance of following guidelines, playing fairly, and working together towards a common goal. Finger paints and water play (choice B) may be more suitable for younger children and may not fully engage 7-year-olds in the same way that structured games would. Dress-up clothes and props (choice C) primarily encourage imaginative play but may not emphasize the same level of cooperation and rule-following as sports and games. Chess and television programs (choice D) may not be as interactive or physically engaging as sports and games, limiting the opportunities for social interaction and cooperation among the children.

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