Nursing Elites

1. A 24-year-old female contracts hepatitis from contaminated food. During the acute (icteric) phase of the patient's illness, what would serologic testing most likely reveal?

• A. antibody to hepatitis D (anti-HDV).
• B. hepatitis B surface antigen (HBsAg).
• C. anti-hepatitis A virus immunoglobulin G (anti-HAV IgG).
• D. anti-hepatitis A virus immunoglobulin M (anti-HAV IgM).

Correct answer: D

Rationale: Hepatitis A is primarily transmitted through the oral-fecal route. During the acute phase of hepatitis A, serologic testing typically reveals anti-hepatitis A virus immunoglobulin M (anti-HAV IgM). This antibody appears early in the course of the infection. The presence of anti-HAV IgM indicates an acute infection with hepatitis A. Choices A and B are incorrect as hepatitis D and hepatitis B antigens are not typically associated with acute hepatitis A. Choice C, anti-hepatitis A virus immunoglobulin G (anti-HAV IgG), would indicate a past infection and lifelong immunity, which is not expected during the acute phase of the illness.

2. The parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism are provided with discharge instructions by the nurse. Which statement by the parents indicates the need for further instruction?

• A. I'll check his temperature.
• B. I'll give him medication so he'll be comfortable.
• C. I'll check his voiding to be sure there's no problem.
• D. I'll let him decide when to return to his play activities.

Correct answer: D

Rationale: Cryptorchidism is a condition where one or both testes fail to descend into the scrotal sac. Orchiopexy, a surgical correction, may be required. After surgery, it is crucial to restrict vigorous activities for 2 weeks to promote healing and prevent injury. Allowing the child to decide when to return to play activities may lead to delayed healing and increased risk of injury, as 2-year-olds typically want to be active. Checking the child's temperature, administering analgesics as needed, and monitoring urine output are important postoperative care measures to ensure recovery and detect complications early. Therefore, the statement indicating the need for further instruction is the one related to letting the child decide when to resume play activities.

3. Which of the following conditions most commonly causes acute glomerulonephritis?

• A. A congenital condition leading to renal dysfunction.
• B. Prior infection with group A Streptococcus within the past 10-14 days.
• C. Viral infection of the glomeruli.
• D. Nephrotic syndrome.

Correct answer: B

Rationale: Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis.

4. A patient diagnosed with alopecia would be described as having:

• A. body lice
• B. lack of ear lobes
• C. Indigestion
• D. hair loss

Correct answer: D

Rationale: The correct answer is 'hair loss.' Alopecia is a medical term that specifically refers to the condition of hair loss, usually in patches or all over the body. Choice A, 'body lice,' refers to a parasitic infestation and is not related to alopecia. Choice B, 'lack of ear lobes,' is completely unrelated to the term alopecia, which is solely about hair loss. Choice C, 'Indigestion,' has no connection to alopecia as it pertains to digestive issues, not hair loss. Therefore, the correct description for a patient diagnosed with alopecia is 'hair loss.'

5. The nurse is caring for a post-surgical client at risk for developing deep vein thrombosis. Which intervention is an effective preventive measure?

• A. Use elastic stockings continuously
• B. Encourage range of motion and ambulation
• C. Massage the legs twice daily
• D. Place pillows under the knees

Correct answer: B

Rationale: Encouraging range of motion and ambulation is an effective preventive measure for deep vein thrombosis in post-surgical clients. Mobility helps improve blood circulation, reducing the risk of clot formation. Elastic stockings help prevent blood pooling and clotting in the legs by providing external pressure to support venous return. Massaging the legs twice daily may help with circulation but is not as effective as promoting movement and ambulation. Placing pillows under the knees is a comfort measure and does not directly address the prevention of deep vein thrombosis.

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