Nursing Elites

1. Which of the following is likely to increase the risk of sexually transmitted disease?

• A. alcohol use
• B. certain types of sexual practices
• C. oral contraception use
• D. all of the above

Correct answer: D

Rationale: All of the above factors are likely to increase the risk of sexually transmitted diseases (STDs). Alcohol use can impair judgment, leading to risky sexual behavior. Certain types of sexual practices, especially unprotected sex or multiple partners, increase the likelihood of contracting STDs. While oral contraception use does not directly increase the risk of STDs, it does not protect against them either. Therefore, all the choices (alcohol use, certain types of sexual practices, and oral contraception use) can contribute to an increased risk of contracting STDs.

2. A 14-year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse's first response be?

• A. Create an atmosphere of seclusion for the boy according to procedures.
• B. Remove other patients from the area for added safety.
• C. Ask the patient, "What is making you mad?"?
• D. Ask the patient, "Why are you behaving this way? Have you thought about what may help you calm down?"?

Correct answer: A

Rationale: In a situation where a patient is agitated and yelling, the first response should be to create an atmosphere of seclusion for the safety of the patient and others. Seclusion is a standard procedure to help manage aggressive behaviors and prevent harm. Options B, C, and D are not appropriate in this scenario. Removing other patients may not address the immediate safety concern, asking the patient what is making them mad can escalate the situation, and questioning why the patient is behaving that way may not help in managing the current agitation. Therefore, seclusion is the recommended course of action in this scenario to ensure the safety and well-being of all involved.

3. Which of the following conditions places a client at risk for developing cirrhosis?

• A. Type I diabetes
• B. Alcoholism
• C. Leukemia
• D. Glaucoma

Correct answer: B

Rationale: Alcoholism places a client at risk for developing cirrhosis due to the liver damage caused by excessive alcohol consumption. Type I diabetes, leukemia, and glaucoma are not directly associated with cirrhosis. While diabetes can lead to other health complications, it does not directly cause cirrhosis. Leukemia is a type of blood cancer that does not affect the liver in a way that leads to cirrhosis. Glaucoma is an eye condition that has no direct link to cirrhosis.

4. A woman is in the active phase of labor. An external monitor has been applied, and a fetal heart deceleration of uniform shape is observed, beginning just as the contraction is underway and returning to the baseline at the end of the contraction. Which of the following nursing actions is most appropriate?

• A. Administer O2.
• B. Turn the client on her left side.
• C. Notify the physician.
• D. No action is necessary

Correct answer: D

Rationale: This scenario describes early deceleration due to head compression, which is a benign finding in labor. Early decelerations mirror the contractions and do not require any intervention as they are considered a normal response to fetal head compression. The fetal heart rate returns to baseline at the end of the contraction. In this case, the correct action is no action at the moment. Close monitoring of the mother and baby is essential, but immediate intervention is not required. Administering O2 (Choice A) or turning the client on her left side (Choice B) is not indicated for early decelerations. Notifying the physician (Choice C) is unnecessary for this type of deceleration.

5. A physician orders a serum creatinine for a hospitalized client. The nurse should explain to the client and his family that this test:

• A. is normal if the level is 4.0 to 5.5 mg/dl.
• B. can be elevated with increased protein intake.
• C. is a better indicator of renal function than the BUN.
• D. reflects the fluid volume status of a person

Correct answer: C

Rationale: A serum creatinine level should be 0.7 to 1.5 mg/dl, and it does not vary with increased protein intake, so it is a better indicator of renal function than the BUN. Choice A is incorrect as a serum creatinine level of 4.0 to 5.5 mg/dl is not normal. Choice B is incorrect as serum creatinine is not affected by increased protein intake. Choice D is incorrect as serum creatinine primarily reflects renal function, not fluid volume status.

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