Which of these clients with associated lab reports is a priority for the nurse to report to the public health department within the next 24 hours?

A. An infant with a positive stool culture for Shigella

B. An elderly factory worker with a positive lab report for acid-fast bacillus smear

C. A young adult commercial pilot with a positive histopathological examination for Pneumocystis carinii from an induced sputum

D. A middle-aged nurse with a history of varicella-zoster virus and crops of vesicles on an erythematous base appearing on the skin

Correct Answer: B
Rationale: The correct answer is B because a positive acid-fast bacillus smear in an elderly factory worker suggests tuberculosis, a serious communicable disease that must be reported promptly to the public health department to prevent its spread. Choice A is incorrect as Shigella is an important pathogen, but it does not require immediate public health reporting. Choice C is incorrect because Pneumocystis carinii is an opportunistic pathogen and does not require urgent public health reporting. Choice D is incorrect as varicella-zoster virus causes chickenpox and shingles, both of which are not reportable diseases to the public health department.

The nurse assesses a 72-year-old client who was admitted for right-sided congestive heart failure. Which of the following would the nurse anticipate finding?

• A. Decreased urinary output
• B. Jugular vein distention
• C. Pleural effusion
• D. Bibasilar crackles

Correct Answer: B
Rationale: In right-sided congestive heart failure, the nurse would anticipate finding jugular vein distention. This occurs due to increased venous pressure, leading to the distention of the jugular veins in the neck. Choices A, C, and D are incorrect. Decreased urinary output is not typically associated with right-sided heart failure; pleural effusion and bibasilar crackles are more commonly seen in conditions like left-sided heart failure.

A nurse is reinforcing teaching with a client who has a colostomy about appropriate food choices. Which of the following foods should the nurse include in the teaching?

• A. Eggs
• B. Grapes
• C. Pasta
• D. Dried fruits

Correct Answer: A
Rationale: The correct answer is A: Eggs. Eggs are a good protein source and are less likely to cause blockage or odor issues in clients with colostomies. Grapes, pasta, and dried fruits can be problematic for individuals with colostomies as they may cause digestive issues, blockages, or increased gas production. Grapes have skins that are hard to digest, pasta can cause constipation or blockage, and dried fruits are high in fiber which can lead to blockages.

A healthcare professional assesses a young adult in the emergency room following a motor vehicle accident. Which of the following neurological signs is of most concern?

• A. Flaccid paralysis
• B. Pupils fixed and dilated
• C. Diminished spinal reflexes
• D. Reduced sensory responses

Correct Answer: B
Rationale: The correct answer is B: Pupils fixed and dilated. Fixed and dilated pupils are a critical neurological sign that indicates severe neurological damage or brain herniation, posing a significant concern for the patient's condition. Flaccid paralysis (choice A) typically indicates lower motor neuron injury, while diminished spinal reflexes (choice C) and reduced sensory responses (choice D) may suggest various neurological issues but are not as acutely concerning as fixed and dilated pupils in this scenario.

A nurse is reinforcing teaching with a client who has Crohn's disease about foods to include in her diet. Which of the following foods should the nurse include in the teaching?

• A. Vanilla milkshake
• B. Buttered popcorn
• C. Broccoli
• D. Grilled chicken breast

Correct Answer: D
Rationale: Grilled chicken breast is a high-protein, low-fiber food that is well-tolerated by clients with Crohn's disease. Crohn's disease is an inflammatory bowel disease that often requires a low-fiber diet to reduce irritation to the digestive tract. Vanilla milkshake is high in dairy and sugar content, which may trigger symptoms in some individuals with Crohn's disease. Buttered popcorn and broccoli are high in fiber, which can be difficult for individuals with Crohn's disease to digest and may exacerbate symptoms.