Nursing Elites

1. A client was re-admitted to the hospital following a recent skull fracture. Which finding requires the nurse's immediate attention?

• A. Lethargy
• B. Agitation
• C. Ataxia
• D. Hearing loss

Correct answer: A

Rationale: Lethargy is a critical finding that requires the nurse's immediate attention when a client with a recent skull fracture is readmitted to the hospital. It can indicate increased intracranial pressure or other serious complications such as hemorrhage or infection. Addressing lethargy promptly is crucial to prevent further deterioration. Agitation, ataxia, and hearing loss are important to assess but do not signify the same level of urgency as lethargy in this context.

2. The nurse is administering the measles, mumps, rubella (MMR) vaccine to a 12-month-old child during the well-baby visit. Which age range should the nurse advise the parents to plan for their child to receive the MMR booster based on the current recommendations and guidelines by the CDC?

• A. 13-18 years of age
• B. 11-12 years of age
• C. 18-24 months of age
• D. 4-6 years of age

Correct answer: D

Rationale: The correct answer is D: 4-6 years of age. The CDC recommends administering the MMR booster to children aged 4 to 6 years. This booster dose is essential to ensure continued immunity against measles, mumps, and rubella. Choices A, B, and C are incorrect because they do not align with the CDC guidelines for the age range of MMR booster administration.

3. When designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States, which healthcare issue should the nurse prioritize the highest when planning the project?

• A. Overuse of diagnostic technology.
• B. Government-based health insurance.
• C. The neonatal and infant mortality rates.
• D. Number of people without access to health care.

Correct answer: C

Rationale: The neonatal and infant mortality rates should be given the highest priority when planning the project because they are critical indicators of the overall health and healthcare system's effectiveness. High neonatal and infant mortality rates signify underlying issues in prenatal care, access to healthcare services, and quality of care for newborns and infants. Choice A, overuse of diagnostic technology, though important, may not be as critical as addressing neonatal and infant mortality rates. Choice B, government-based health insurance, is significant but may not directly impact neonatal and infant mortality rates. Choice D, the number of people without access to healthcare, is a crucial issue, but addressing neonatal and infant mortality rates should take precedence due to their immediate impact on the health and well-being of the most vulnerable population.

4. A client with a fractured femur is in Buck's traction. The nurse should assess for which of the following complications?

• A. Foot drop
• B. Urinary retention
• C. Constipation
• D. Muscle spasms

Correct answer: A

Rationale: Corrected Rationale: Foot drop is a potential complication of prolonged immobility and improper positioning in traction. In Buck's traction, the lower extremity is suspended to immobilize and align the fractured femur. Prolonged suspension of the leg in traction can lead to nerve damage, specifically to the common peroneal nerve, resulting in foot drop. Urinary retention, constipation, and muscle spasms are not directly associated with Buck's traction and a fractured femur.

5. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

• A. Congenital cardiac defects
• B. An acute febrile illness
• C. Prolonged hypoxemia
• D. Severe multiple trauma

Correct answer: C

Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.

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