Nursing Elites

1. A nurse is assessing a newborn 1 hour after birth. The newborn has acrocyanosis and a heart rate of 130 beats per minute. Which of the following actions should the nurse take?

• A. Place the newborn under a radiant warmer
• B. Apply oxygen
• C. Swaddle the newborn
• D. Reassess the newborn in 1 hour

Correct answer: D

Rationale: Acrocyanosis, a bluish discoloration of the hands and feet, is a normal finding in newborns within the first few hours after birth. The heart rate of 130 beats per minute is also within the normal range for a newborn. These findings are typical and do not require immediate intervention. The appropriate action for the nurse is to continue monitoring the newborn. Reassessing the newborn in 1 hour allows the nurse to observe any changes and ensure the newborn's condition remains stable. Placing the newborn under a radiant warmer or applying oxygen is not necessary as the newborn's condition is within normal limits. Swaddling the newborn may provide comfort but is not the priority action in this scenario.

2. A nurse is planning a staff education program to review nursing interventions for patients who have kidney failure. What source should the nurse identify as the best source for obtaining evidence-based practice information?

• A. A recent peer-reviewed nursing research article
• B. A website for a nursing association
• C. A textbook published 5 years ago
• D. An expert opinion from a seasoned nurse

Correct answer: A

Rationale: The correct answer is A: A recent peer-reviewed nursing research article. Peer-reviewed research articles provide the most current and reliable evidence-based practice information for clinical care. Choice B, a website for a nursing association, may have valuable information but may not always guarantee the highest level of evidence. Choice C, a textbook published 5 years ago, may not reflect the most up-to-date practices and guidelines. Choice D, an expert opinion from a seasoned nurse, though valuable, is not as reliable as evidence derived from peer-reviewed research articles.

3. A client is experiencing urinary incontinence, and a nurse is providing care. Which of the following recommendations should the nurse include in the teaching plan for this client?

• A. Drink large amounts of water before bedtime
• B. Perform Kegel exercises regularly
• C. Limit fiber intake in the diet to avoid bowel irritation
• D. Increase intake of caffeinated and carbonated beverages

Correct answer: B

Rationale: The correct recommendation for a client experiencing urinary incontinence is to perform Kegel exercises regularly. These exercises help strengthen the pelvic floor muscles, improving bladder control and reducing urinary incontinence. Option A is incorrect because drinking large amounts of water before bedtime can worsen urinary incontinence by increasing urine production. Option C is incorrect as fiber is important for bowel health and limiting it may not be beneficial for the client. Option D is incorrect as caffeinated and carbonated beverages can irritate the bladder and worsen urinary incontinence, so they should be avoided.

4. A nurse is assessing a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

• A. Meat and dairy products are eaten together
• B. Fasting occurs during Hanukkah
• C. Shellfish is eaten regularly
• D. Meat and dairy products are consumed separately

Correct answer: D

Rationale: The correct answer is D: 'Meat and dairy products are consumed separately.' Kosher dietary laws prohibit the consumption of meat and dairy products together. Observing this separation is a key aspect of Jewish dietary practices. Choice A is incorrect as meat and dairy products are not eaten together in kosher dietary practices. Choice B is incorrect as fasting does not typically occur during Hanukkah. Choice C is incorrect as shellfish is not eaten in kosher dietary practices due to being non-kosher.

5. A nurse is caring for a client who is in the third trimester of pregnancy and has gestational diabetes. Which of the following complications is the fetus at risk for?

• A. Macrosomia
• B. Hydrocephalus
• C. Cleft palate
• D. Spina bifida

Correct answer: A

Rationale: The correct answer is A: Macrosomia. Gestational diabetes can result in fetal macrosomia, a condition where the baby grows larger than normal due to excess glucose in the mother's blood. This increases the risk of complications during delivery. Choices B, C, and D are incorrect. Hydrocephalus is an abnormal accumulation of cerebrospinal fluid within the brain. Cleft palate is a congenital condition where there is a split or opening in the roof of the mouth. Spina bifida is a neural tube defect characterized by the incomplete development of the spinal cord or its coverings.

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