Nursing Elites

1. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

2. A parent of an infant with congenital hypothyroidism is receiving teaching from a nurse. Which of the following statements should the nurse include in the teaching?

• A. Your child will need to take medication for a few months
• B. You will need to give your child the medication every other day
• C. Your child will need to take the medication until age 10
• D. Your child will need to take the medication for life

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism requires lifelong medication to manage the condition effectively. The nurse should emphasize to the parent that their child will need to take the medication for life to ensure proper thyroid hormone levels and prevent complications associated with hypothyroidism.

3. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

4. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

5. Which stage of motor learning is illustrated as the toddler attempts to place a shape into a container multiple times using an effective reach and grasp pattern often but makes errors?

• A. Skill Acquisition
• B. Perceptual Learning
• C. Functional Performance
• D. Exploratory Activity

Correct answer: B

Rationale: The correct answer is Perceptual Learning. In this stage, the toddler learns from sensory input and refines their movements over time, even though errors may still occur. This process involves improving coordination and fine-tuning motor skills based on feedback from repeated attempts.

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