Nursing Elites

1. During a physical assessment of a newborn, what finding should the nurse prioritize reporting?

• A. Head circumference of 40 cm
• B. Chest circumference of 32 cm
• C. Acrocyanosis and edema of the scalp
• D. Heart rate of 160 bpm and respirations of 40/min

Correct answer: A

Rationale: The correct answer is A because a head circumference of 40 cm is unusually large for a newborn, which may indicate hydrocephalus or other abnormalities. Reporting this finding is crucial for further evaluation and intervention. Choices B, C, and D are not as concerning during a newborn physical assessment. A chest circumference of 32 cm is within the normal range for a newborn. Acrocyanosis and edema of the scalp are common findings in newborns and usually resolve without intervention. While a heart rate of 160 bpm and respirations of 40/min should be monitored, they are not as critical as an unusually large head circumference.

2. Which of the following drugs contribute to peptic ulcers?

• A. Antacids
• B. Certain antibiotics
• C. Cholesterol-lowering medications
• D. Nonsteroidal anti-inflammatory drugs

Correct answer: D

Rationale: The correct answer is D: Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are known to contribute to peptic ulcers by affecting the gastric mucosa. Choice A, Antacids, actually help to alleviate symptoms of peptic ulcers by neutralizing stomach acid. Choice B, Certain antibiotics, are used to treat H. pylori infections, a common cause of peptic ulcers. Choice C, Cholesterol-lowering medications, do not contribute to peptic ulcers.

3. The nurse enters a client’s room and the client is demanding release from the hospital. The nurse reviews the client’s record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder, and the admission was voluntary. Which intervention should the nurse initiate first?

• A. Telephone the client’s family and have them persuade the client to stay
• B. Have the client read and sign all the appropriate self-discharge papers
• C. Explain to the client that he cannot leave because he asked for treatment
• D. Notify the client’s healthcare provider of the client’s stated intent to leave the hospital

Correct answer: D

Rationale: The correct intervention for the nurse to initiate first is to notify the client’s healthcare provider of the client’s intention to leave the hospital. This is important to ensure that the client’s care and safety are appropriately managed. Option A is incorrect as involving the family without proper assessment or intervention could violate the client's autonomy. Option B is incorrect because it does not involve the healthcare provider in the decision-making process. Option C is incorrect as it does not address the client's rights to make decisions about their own care.

4. The nurse is teaching basic cardiopulmonary resuscitation (CPR) to individuals in the community. What is the correct order of basic CPR steps?

• A. Ensure the scene is safe, assess responsiveness, call for help, begin chest compressions, give two rescue breaths
• B. Give two rescue breaths
• C. Look, listen, and feel for breathing
• D. Begin chest compressions

Correct answer: A

Rationale: The correct order of basic CPR steps is as follows: first, ensure the scene is safe to approach, then assess the individual's responsiveness. After confirming the need for help, start chest compressions, then provide two rescue breaths. Option B, 'Give two rescue breaths,' is incorrect as chest compressions should be initiated before giving rescue breaths. Option C, 'Look, listen, and feel for breathing,' is also incorrect as immediate chest compressions are crucial in CPR. Option D, 'Begin chest compressions,' is partially correct but misses the crucial initial steps of ensuring scene safety and assessing responsiveness.

5. The client with peripheral venous disease is scheduled to go to the whirlpool for a dressing change. Which is the nurse’s priority intervention?

• A. Escort the client to the physical therapy department
• B. Medicate the client 30 minutes before going to the whirlpool
• C. Obtain the sterile dressing supplies for the client
• D. Assist the client to the bathroom prior to the treatment

Correct answer: B

Rationale: The correct answer is B. Pain management is essential before the procedure to ensure the client’s comfort and cooperation during the dressing change. Escorting the client to the physical therapy department (choice A) is not the priority at this time. While obtaining sterile dressing supplies (choice C) is important, ensuring pain management takes precedence. Assisting the client to the bathroom (choice D) is not directly related to the priority intervention of pain management before the whirlpool treatment.

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