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A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)
- A. Botulism is acquired through direct contact with an infected person.
- B. Notify the Centers for Disease Control and Prevention (CDC) when more than three cases are confirmed.
- C. Botulism can produce paralysis within 12 to 72 hours following exposure.
- D. Vomiting and diarrhea are expected findings following exposure.
- E. Botulism is a toxin found in castor beans.
Correct Answer: C,D
Rationale: The correct answers are C and D. Choice C is correct because botulism can indeed produce paralysis within 12 to 72 hours following exposure. This is crucial information for early detection and treatment. Choice D is also correct because vomiting and diarrhea are not typical symptoms of botulism. The toxin primarily affects the nervous system, leading to symptoms such as muscle weakness and paralysis. Choices A, B, and E are incorrect. Botulism is not acquired through direct contact with an infected person (A), the CDC should be notified immediately upon suspicion of botulism, not after a certain number of cases (B), and botulism toxin is not found in castor beans (E).
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A community health nurse is developing a pamphlet about breast self-examination (BSE) for a local health fair. Which of the following instructions should the nurse include?
- A. Using the palm of the hand, feel for lumps using a circular motion.
- B. Expect some breast dimpling or discharge with age.
- C. Breasts can be examined in the shower with soapy hands.
- D. For those who have a menstrual cycle, perform a BSE every month, 2 or 3 days before menstruation.
Correct Answer: C
Rationale: The correct answer is C: Breasts can be examined in the shower with soapy hands. This instruction is important because warm water and soap help to make the examination more comfortable and easier to detect any abnormalities. By examining the breasts in the shower, the individual can incorporate BSE into their routine without it feeling like a separate task. This method also allows for better coverage and thorough examination of the entire breast tissue.
Choice A is incorrect because using the palm of the hand in a circular motion may not be as effective in detecting lumps compared to using the fingertips. Choice B is incorrect as breast dimpling or discharge are not normal signs of aging, and should be reported to a healthcare provider. Choice D is incorrect as performing BSE at specific times in the menstrual cycle is not necessary.
A nurse in a provider’s office is assessing a client who has rheumatoid arthritis (RA). Which of the following findings is a late manifestation?
- A. Low-grade fever
- B. Weight loss
- C. Anorexia
- D. Knuckle deformity
Correct Answer: D
Rationale: The correct answer is D: Knuckle deformity. Knuckle deformity in rheumatoid arthritis is a late manifestation due to prolonged inflammation and joint damage. This occurs after the initial symptoms such as low-grade fever, weight loss, and anorexia. Low-grade fever, weight loss, and anorexia are early systemic manifestations of RA caused by inflammation and metabolic changes. Knuckle deformity indicates advanced joint damage and chronic inflammation. Therefore, it is considered a late manifestation compared to the other options.
A nurse is preparing to turn a client who is obese following a spinal fusion. The nurse should plan to use which of the following techniques to turn this client?
- A. Draw sheet
- B. Log roll
- C. Sliding board
- D. Hoyer lift
Correct Answer: B
Rationale: The correct answer is B: Log roll. When turning an obese client following spinal fusion, using a log roll technique is most appropriate. This technique involves turning the client as a single unit to prevent twisting or bending of the spine, reducing the risk of injury. The nurse should assist the client by coordinating the movement with other staff members to ensure a smooth and safe transition. The other choices are not suitable for this scenario: A) Draw sheet is typically used for moving a client up in bed, not for turning an obese client after spinal fusion. C) Sliding board is used for transferring clients from one surface to another, not for turning in bed. D) Hoyer lift is used for lifting and transferring clients who are unable to bear weight, not for turning a client in bed.
A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include?
- A. You can expect swelling of the ankles while taking this medication.
- B. Do not take this medication on an empty stomach.
- C. Limit your fluid intake to meal times.
- D. Increase your daily intake of dietary fiber.
Correct Answer: D
Rationale: The correct answer is D: Increase your daily intake of dietary fiber. Verapamil, a calcium channel blocker used for angina, can cause constipation as a side effect. Increasing dietary fiber helps prevent constipation by promoting bowel regularity. This instruction is important for the client's overall well-being and medication compliance.
A: Swelling of the ankles is not a common side effect of verapamil.
B: Verapamil can be taken with or without food, so taking it on an empty stomach is not necessary.
C: There is no need to limit fluid intake to meal times while taking verapamil.
A public health nurse is teaching a group of nurses about smallpox. Which of the following statements by one of the nurses indicates understanding of the teaching?
- A. Unlike chickenpox, the vesicles of smallpox are more abundant on the face.
- B. Smallpox lesions appear in various stages of healing.
- C. Vaccination against smallpox provides lifelong immunity.
- D. There are rare, occasional occurrences of smallpox.
Correct Answer: A
Rationale: The correct answer is A because smallpox vesicles are more abundant on the face compared to chickenpox. This is a key characteristic of smallpox that differentiates it from chickenpox. Option B is incorrect because smallpox lesions all appear at the same stage. Option C is incorrect as smallpox vaccination does not provide lifelong immunity. Option D is incorrect as smallpox has been eradicated, so occurrences are not rare but non-existent.