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. Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?

• A. An undescended testicle can reduce fertility.
• B. The testicle usually descends spontaneously during the first month of life.
• C. Surgical correction reduces the risk for testicular tumors.
• D. The optimal time to surgically correct the condition is at diagnosis.

Correct answer: A

Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.

3. A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight � 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours?

• A. 88 mL/hr
• B. 86 mL/hr
• C. 81 mL/hr
• D. 83 mL/hr

Correct answer: B

Rationale: For 13 kg, the maintenance fluid is 1150 mL (1000 mL for first 10 kg + 3*50 mL for the remaining 3 kg). Replacement fluid is 910 mL (0.07 * 13000 mL). Total fluid is 2060 mL, divided by 24 hours is 86 mL/hr.

4. When teaching an adolescent about managing tinea pedis, which statement indicates an understanding of the teaching?

• A. I should buy some plastic shoes to wear at the swimming pool
• B. I should wear sandals as much as possible
• C. I should place the permethrin cream between my toes twice daily
• D. I should seal my non-washable shoes in plastic bags for a couple of weeks

Correct answer: B

Rationale: Wearing sandals allows air circulation around the feet, reducing perspiration and eliminating the environment for bacteria and fungus to thrive. This promotes the healing of the fungal infection. Therefore, the correct answer is B.

5. The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?

• A. Analyze HR and rhythm
• B. Assess for Homan�s sign
• C. Check BP
• D. Palpate the pedal pulses

Correct answer: A

Rationale: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60 bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.

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