Nursing Elites

1. A 36-year-old male patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. Which action by the nurse is appropriate?

• A. Schedule the patient for HCV genotype testing.
• B. Administer the HCV vaccine and immune globulin.
• C. Teach the patient about ribavirin (Rebetol) treatment.
• D. Explain that the infection will resolve over a few months.

Correct answer: A

Rationale: The correct action by the nurse is to schedule the patient for HCV genotype testing. Genotyping of HCV is crucial in determining the appropriate treatment regimen and guiding therapy decisions. Most patients with acute HCV infection progress to the chronic stage, so it is incorrect to inform the patient that the infection will resolve in a few months. There is no vaccine or immune globulin available for HCV, and ribavirin (Rebetol) is typically used for chronic HCV infection. Therefore, the nurse should prioritize genotyping to assist in treatment planning.

2. Which goal has the highest priority in the plan of care for a 26-year-old homeless patient admitted with viral hepatitis who has severe anorexia and fatigue?

• A. Increase activity level.
• B. Maintain adequate nutrition
• C. Establish a stable environment
• D. Identify sources of hepatitis exposure

Correct answer: B

Rationale: The highest priority outcome is to maintain adequate nutrition because it is essential for hepatocyte regeneration. In viral hepatitis, the liver is affected, and proper nutrition supports the liver's function and regeneration. While increasing activity level and establishing a stable environment are important, they are not as urgent as ensuring the patient receives proper nutrition. Identifying sources of hepatitis exposure can help prevent future infections, but in the acute phase, the immediate focus should be on providing adequate nutrition to support the patient's recovery.

3. When assessing a child admitted to the hospital with pyloric stenosis, which symptom would the nurse likely find when asking the parent about the child's symptoms?

• A. Watery diarrhea
• B. Projectile vomiting
• C. Increased urine output
• D. Vomiting large amounts of bile

Correct answer: B

Rationale: In pyloric stenosis, hypertrophy of the circular muscles of the pylorus causes narrowing of the pyloric canal between the stomach and the duodenum. The hallmark symptom of pyloric stenosis is projectile vomiting, which is the forceful expulsion of stomach contents. Other common symptoms include irritability, hunger and crying, constipation, and signs of dehydration. Watery diarrhea (Choice A) is not a typical symptom of pyloric stenosis. Increased urine output (Choice C) is not directly associated with this condition. Vomiting large amounts of bile (Choice D) is not a characteristic symptom of pyloric stenosis; instead, the vomitus in pyloric stenosis is non-bilious.

4. A patient asks a nurse administering blood how long red blood cells live in the body. What is the correct response?

• A. The life span of RBC is 45 days
• B. The life span of RBC is 60 days
• C. The life span of RBC is 90 days
• D. The life span of RBC is 120 days

Correct answer: D

Rationale: The correct answer is that red blood cells have a lifespan of 120 days in the body. This allows for efficient oxygen transport throughout the circulatory system. Choices A, B, and C are incorrect because the lifespan of red blood cells is actually 120 days. Understanding the lifespan of red blood cells is crucial in assessing various conditions related to blood cell production and turnover.

5. A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse least likely to find in an abusing parent?

• A. Low self-esteem
• B. Unemployment
• C. Self-blame for the injury to the child
• D. Single status

Correct answer: C

Rationale: The profile of a parent at risk of abusive behavior includes a tendency to blame the child or others for the injury sustained. Abusers typically blame others, especially their partners, for the mistakes in their lives. This is related to hypersensitivity, but they are not necessarily alike. This occurs because most abusive people don't hold themselves as being accountable for the actions they commit. Instead, they'll try to shift the blame to the person that they have abused and somehow say they "deserved it"? or that they were forced into a corner.

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