A client turns her ankle. She is diagnosed as having a Pulled Ligament. This should be documented as a:
- A. sprain.
- B. strain.
- C. subluxation.
- D. dislocation.
Correct Answer: B
Rationale: A sprain is the correct term for the excessive stretching of a ligament, which is what happens when a ligament is pulled. A strain involves muscle tissue. Subluxation refers to a partial dislocation, and dislocation is a complete displacement of bones in a joint. In this case, since it's a pulled ligament, the most appropriate term is a sprain.
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The healthcare provider sustains a needle puncture that requires HIV prophylaxis. Which of the following medication regimens should be used?
- A. an antibiotic such as Metronidazole and a protease inhibitor (Saquinavir)
- B. two non-nucleoside reverse transcriptase inhibitors
- C. one protease inhibitor such as Nelfinavir
- D. two protease inhibitors
Correct Answer: B
Rationale: In the scenario of a needle puncture requiring HIV prophylaxis, the CDC recommends initiating treatment with two non-nucleoside reverse transcriptase inhibitors, unless there is drug resistance. This regimen is preferred over other options such as a single protease inhibitor or two protease inhibitors due to its effectiveness and safety profile in this specific context. Non-nucleoside reverse transcriptase inhibitors are commonly used in post-exposure prophylaxis due to their activity against HIV and lower risk of resistance development compared to other antiretroviral drug classes.
Following a recent tattoo, someone should be screened for:
- A. tuberculosis.
- B. herpes.
- C. hepatitis.
- D. syphilis.
Correct Answer: C
Rationale: Following a recent tattoo, someone should be screened for hepatitis. Tattooing puts a client at risk for blood-borne hepatitis B or C if strict sterile procedures are not followed. Tuberculosis is an airborne pathogen, while herpes and syphilis are spread through direct contact like sexual activity. Therefore, hepatitis is the most relevant infection to screen for after getting a tattoo.
People living in poverty are most likely to obtain health care from:
- A. their primary care physician (family doctor)
- B. a neighborhood clinic
- C. specialists
- D. Emergency Departments or urgent care centers
Correct Answer: D
Rationale: People living in poverty often face barriers to accessing regular healthcare services, leading them to seek care in Emergency Departments or urgent care centers. These facilities are more accessible and do not require appointments or insurance, making them a common choice for individuals with limited resources. Neighborhood clinics, while a good option, may not always be available or affordable for those in poverty. Specialists provide specialized care but usually require a referral from a primary care provider, which individuals in poverty may not have consistent access to. Therefore, Emergency Departments or urgent care centers are the most likely sources of healthcare for people living in poverty.
A client with which of the following conditions is at risk for developing a high ammonia level?
- A. renal failure
- B. psoriasis
- C. lupus
- D. cirrhosis
Correct Answer: D
Rationale: A client with cirrhosis is at risk for developing a high ammonia level due to impaired liver function. The liver normally converts ammonia into urea for excretion. In cirrhosis, this process is compromised, leading to elevated ammonia levels in the blood. Renal failure, psoriasis, and lupus do not typically cause high ammonia levels. Renal failure affects kidney function, while psoriasis and lupus are autoimmune conditions that do not directly impact ammonia metabolism.
A young boy is recently diagnosed with a seizure disorder. Which of the following statements by the boy's mother indicates a need for further teaching by the nurse?
- A. "I should make sure he gets plenty of rest."?
- B. "I should get him a medical alert bracelet."?
- C. "I should lay him on his back during a seizure."?
- D. "I should loosen his clothing during a seizure."?
Correct Answer: C
Rationale: The correct answer is "I should lay him on his back during a seizure."? This statement indicates a need for further teaching because a client having a seizure should be turned to the side to prevent aspiration of secretions. Choices A, B, and D are correct. Getting plenty of rest helps in managing seizures, having a medical alert bracelet informs others about the condition in case of emergency, and loosening clothing during a seizure ensures better air circulation and prevents injury. These actions demonstrate adequate understanding of the teaching provided.