Nursing Elites

1. A nurse in a provider's office is assessing the motor skill development of a 15-month-old toddler during a well-child visit. What gross motor skills should the nurse expect to observe?

• A. Walks without assistance using a wide stance
• B. Climbs stairs with assistance
• C. Runs smoothly
• D. Kicks a ball forward

Correct answer: A

Rationale: The correct answer is A. At 15 months, toddlers typically walk independently but may do so with a wide stance for balance. Choice B, climbing stairs with assistance, is more common around 18 months. Choice C, running smoothly, is usually achieved around 2 years of age. Choice D, kicking a ball forward, generally develops around 2 to 3 years of age. Therefore, for a 15-month-old toddler, the nurse should expect the child to walk without assistance using a wide stance for balance.

2. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?

• A. Low potassium diet
• B. High fiber diet
• C. Low fat diet
• D. Low sodium diet

Correct answer: C

Rationale: The correct answer is C: 'Low fat diet.' A client with chronic cholecystitis should follow a low-fat diet to decrease the frequency of biliary colic episodes. Fats can trigger the release of cholecystokinin, which stimulates the gallbladder to contract, potentially causing pain in individuals with cholecystitis. Choices A, B, and D are incorrect. A low potassium diet is prescribed for individuals with specific kidney conditions or on certain medications. A high fiber diet is beneficial for conditions like constipation, diverticulosis, or to promote general bowel health. A low sodium diet is often recommended for conditions like hypertension or heart failure to reduce fluid retention.

3. A nurse is preparing to administer a pneumococcal vaccine. Which of the following should the nurse verify?

• A. Client's allergy to eggs
• B. Client's current medications
• C. Client's vaccination history
• D. Client's blood pressure

Correct answer: C

Rationale: The correct answer is C: Client's vaccination history. Before administering a pneumococcal vaccine, the nurse should verify the client's vaccination history to ensure they are due for the vaccine. Verifying the vaccination history helps prevent unnecessary vaccinations and ensures that the client receives the appropriate immunization at the right time. Choices A, B, and D are not directly related to the administration of the pneumococcal vaccine. Checking for allergies to eggs may be important for other vaccines, but it is not specifically relevant to pneumococcal vaccination. The client's current medications and blood pressure are important for general health assessment but are not directly related to verifying the need for a pneumococcal vaccine.

4. A nurse is assessing a client who gave birth 1 week ago. The client states, 'I don't know what's wrong. I love my baby, but I feel so let down and I seem to cry for no reason.' The nurse should identify that the client is experiencing which of the following emotional responses to birth?

• A. Postpartum depression
• B. Taking-in phase
• C. Postpartum blues
• D. Taking-hold phase

Correct answer: C

Rationale: The client is experiencing postpartum blues, not postpartum depression. Postpartum blues are common and characterized by mood swings, tearfulness, and emotional letdown shortly after delivery. The 'Taking-in phase' involves the mother focusing on her own needs, while the 'Taking-hold phase' is characterized by a desire to learn and feel competent in caring for the baby. Postpartum depression is a more severe and long-lasting condition that requires professional intervention.

5. A healthcare professional is assessing a client for signs of anaphylaxis. Which of the following findings should the healthcare professional look for?

• A. Bradycardia
• B. Hypotension
• C. Increased appetite
• D. Decreased respiratory rate

Correct answer: B

Rationale: Hypotension is a critical sign of anaphylaxis. During anaphylaxis, there is a widespread vasodilation leading to a drop in blood pressure, which manifests as hypotension. This can be accompanied by other symptoms such as swelling, difficulty breathing, hives, and itching. Bradycardia (choice A) is not typically associated with anaphylaxis; instead, tachycardia is more common due to the body's response to the allergic reaction. Increased appetite (choice C) is unrelated to anaphylaxis, as individuals experiencing anaphylaxis often feel unwell and may have nausea or vomiting. Decreased respiratory rate (choice D) is also not a typical finding in anaphylaxis; instead, respiratory distress and wheezing are more commonly observed.

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