Nursing Elites

1. When asked to describe in layman's terms an overview of the condition called osteomyelitis, what would be the nurse's best response?

• A. Osteomyelitis is a gradual breakdown and weakening of your bones. It's most often age-related.
• B. Osteomyelitis is caused by not having enough Vitamin D, which in turn causes your bones to be softer and demineralized.
• C. Osteomyelitis is an infection in the bone. It can be caused by bacteria reaching your bone from outside or inside your body.
• D. This is a question that should be directed to your healthcare provider.

Correct answer: C

Rationale: Osteomyelitis is an infection in the bone that can be caused by bacteria reaching the bone either from outside the body (such as through an open fracture) or inside the body (such as through the bloodstream). This response provides a concise and accurate explanation of osteomyelitis, making it the best choice. Choices A and B provide inaccurate information about the condition, attributing it to age-related bone breakdown and Vitamin D deficiency, which are not correct causes of osteomyelitis. Choice D deflects the question instead of providing the patient with a clear explanation, making it an inappropriate response.

2. The parents of a newborn have been told that their child was born with bladder exstrophy, and the parents ask the nurse about this condition. Which explanation, given by the parents, indicates understanding of this condition?

• A. ''It's a hereditary disorder that occurs in every other generation.''
• B. ''It is caused by the use of medications taken by the mother during pregnancy.''
• C. ''It is a condition in which the urinary bladder is abnormally located in the pelvic cavity.''
• D. ''It's an extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall.''

Correct answer: D

Rationale: Bladder exstrophy is a congenital anomaly characterized by the extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall. The cause of bladder exstrophy is not precisely known, but it is believed to be due to a developmental abnormality during embryogenesis. The condition is more common in male newborns. Choice A is incorrect as bladder exstrophy is not a hereditary disorder that occurs in every other generation. Choice B is incorrect as bladder exstrophy is not caused by medications taken by the mother during pregnancy. Choice C is incorrect as it describes the condition inaccurately; it is not just an abnormal location of the bladder in the pelvic cavity, but rather an extrusion of the bladder outside the body through a defect in the lower abdominal wall.

3. A 24-year-old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?

• A. Diverticulosis
• B. Hypercalcemia
• C. Hypocalcemia
• D. Irritable bowel syndrome

Correct answer: B

Rationale: The correct answer is Hypercalcemia. In this case, the patient's history of myeloma, constipation, intense abdominal pain, and polyuria suggests hypercalcemia. Elevated calcium levels can lead to polyuria, severe abdominal pain, and confusion. Diverticulosis (Choice A), characterized by small pouches in the colon wall, typically does not present with confusion and polyuria. Hypocalcemia (Choice C) is unlikely given the symptoms described. Irritable bowel syndrome (Choice D) does not typically cause confusion and polyuria as seen in hypercalcemia.

4. Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?

• A. Did your child fall off a bike onto the handlebars?
• B. Has the child had persistent nausea and vomiting?
• C. Has the child been itching or had a rash anytime in the last week?
• D. Has the child had a sore throat or a throat infection in the last few weeks?

Correct answer: D

Rationale: Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Group A ?-hemolytic streptococcal infection is a common cause of glomerulonephritis. Children with glomerulonephritis often develop symptoms after a throat infection caused by streptococcal bacteria. Therefore, asking about a sore throat or throat infection in the last few weeks is crucial to assess the possible link to glomerulonephritis. Choices A, B, and C are not directly associated with the pathophysiology of glomerulonephritis. Asking about falling off a bike, nausea and vomiting, or itching and rash do not provide relevant information for assessing glomerulonephritis in this context.

5. A newborn infant in the nursery has developed vomiting, poor feeding, lethargy, and respiratory distress, and has been diagnosed with necrotizing enterocolitis. Which of the following nursing interventions is most appropriate for this infant?

• A. Feed the infant 30 cc of sterile water
• B. Position the infant on his back
• C. Administer antibiotics as ordered
• D. Allow the infant to breastfeed

Correct answer: C

Rationale: Necrotizing enterocolitis (NEC) is a serious condition characterized by ischemic bowel, leading to gastrointestinal symptoms, lethargy, poor feeding, and respiratory distress. In the management of NEC, it is crucial to stop oral feedings, insert a nasogastric tube for decompression, and administer antibiotics as prescribed by the physician. Therefore, the most appropriate nursing intervention for an infant with NEC is to administer antibiotics as ordered. Choice A, feeding the infant sterile water, is incorrect because oral feedings should be stopped in NEC. Choice B, positioning the infant on his back, is not directly related to the treatment of NEC. Choice D, allowing the infant to breastfeed, is contraindicated in NEC as oral feedings should be ceased to prevent further complications.

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