Nursing Elites

1. While in an induced coma for 3 weeks, a badly burned firefighter awakens and thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

• A. Cerebellum
• B. Thalamus
• C. Temporal lobe
• D. Occipital lobe

Correct answer: C

Rationale: The temporal lobe is responsible for processing auditory information, allowing the patient to hear and comprehend while in a coma. The cerebellum is primarily associated with coordination and balance, not auditory processing. The thalamus serves as a relay station for sensory information but is not specifically responsible for auditory processing. The occipital lobe is mainly involved in processing visual information, not auditory functions.

2. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?

• A. Use a visual analog scale (VAS) to assess the pain.
• B. Ask the child to rate their pain on a scale of 0 to 10.
• C. Use the Wong-Baker FACES scale to assess the pain.
• D. Ask the parents to describe the child's pain behavior.

Correct answer: C

Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.

3. A patient is receiving oral nystatin suspension for a fungal infection of the mouth. Which of the following adverse effects is most likely to be experienced with this form of nystatin?

• A. Local irritation
• B. Burning
• C. Nausea
• D. Urinary urgency

Correct answer: A

Rationale: The correct answer is A: Local irritation. When using oral nystatin suspension for a fungal infection of the mouth, local irritation is the most likely adverse effect that a patient may experience. Nystatin is generally well-tolerated, but some patients may develop local irritation, such as mouth or throat irritation. Choices B, C, and D are less likely adverse effects of oral nystatin suspension. Burning, nausea, and urinary urgency are not commonly associated with nystatin use for a fungal infection of the mouth.

4. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Has your child received all recommended vaccinations?
• B. Has your child been feeding poorly or showing signs of constipation?
• C. Has your child been exposed to any sick individuals?
• D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

5. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

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