Nursing Elites

1. 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.

2. The healthcare provider would expect which eating disorder to have the greatest fluctuations in potassium?

• A. Binge eating disorder
• B. Anorexia nervosa
• C. Bulimia
• D. Purge syndrome

Correct answer: C

Rationale: The correct answer is C: Bulimia. Bulimia involves cycles of binge eating and purging, where individuals may induce vomiting or use laxatives and diuretics. These purging behaviors can lead to significant fluctuations in potassium levels due to electrolyte imbalances caused by excessive loss of potassium through vomiting and purging. In contrast, Binge eating disorder (A) does not involve purging behaviors, so it is less likely to cause significant potassium fluctuations. Anorexia nervosa (B) is characterized by severe food restriction rather than purging, leading to a different pattern of electrolyte imbalances. Purge syndrome (D) is not a recognized eating disorder and is not associated with specific patterns of potassium fluctuations seen in bulimia.

3. A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of 'suppression'?

• A. "I don't remember anything about what happened to me."
• B. "I'd rather not talk about it right now."
• C. "It's all the other guy's fault! He was going too fast."
• D. "My mother is heartbroken about this."

Correct answer: B

Rationale: The correct answer is B because the statement "I'd rather not talk about it right now" indicates that the client is consciously choosing to avoid discussing the distressing issue, which aligns with the mechanism of suppression. Choice A does not involve active avoidance but rather memory loss, which is not suppression. Choice C involves blaming others, which is a defense mechanism known as projection. Choice D involves expressing emotions rather than avoiding them, which does not align with suppression.

4. What is a key component of a successful smoking cessation program?

• A. Providing nicotine replacement therapy
• B. Offering surgical interventions
• C. Conducting regular health screenings
• D. Promoting alcohol consumption

Correct answer: A

Rationale: The correct answer is A. Providing nicotine replacement therapy is a key component of smoking cessation programs as it helps individuals manage nicotine withdrawal symptoms. Nicotine replacement therapy includes options like nicotine gum, patches, lozenges, or inhalers. Choice B, offering surgical interventions, is incorrect as smoking cessation programs primarily focus on behavioral and pharmacological interventions rather than surgical procedures. Choice C, conducting regular health screenings, is also incorrect as it is not a direct key component of smoking cessation programs. Choice D, promoting alcohol consumption, is not only incorrect but counterproductive, as it can be detrimental to overall health and hinder smoking cessation efforts.

5. While performing an initial assessment on a newborn following a breech delivery, the nurse suspects hip dislocation. Which of the following is most suggestive of the abnormality?

• A. Flexion of lower extremities
• B. Negative Ortolani response
• C. Lengthened leg of affected side
• D. Irregular hip symmetry

Correct answer: D

Rationale: Irregular hip symmetry, such as asymmetry in the gluteal folds, is a common sign of hip dislocation in newborns. This finding indicates a potential abnormality in hip development and requires further evaluation and possible treatment. Choices A, B, and C are incorrect. Flexion of lower extremities is a normal newborn reflex, the Ortolani response is used to detect hip dysplasia rather than hip dislocation, and a lengthened leg of the affected side is not typically associated with hip dislocation in newborns.

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