Nursing Elites

1. When assisting the physician in performing transillumination of a client's scrotum, how should the nurse prepare for this procedure?

• A. Obtaining a flashlight and darkening the room
• B. Instructing the client to drink three glasses of water
• C. Instructing the client to take several deep breaths and bear down
• D. Telling the client that the procedure is very uncomfortable but that the discomfort will only last for a few moments

Correct answer: A

Rationale: When preparing for transillumination of the scrotum, the nurse should obtain a flashlight and darken the room. This is done to allow the strong flashlight to be shined from behind the scrotal contents. Normal scrotal contents do not appear on transillumination. Instructing the client to drink fluids or to take deep breaths and bear down is not part of the preparation for this procedure. Additionally, it is not necessary to inform the client that the procedure is uncomfortable as transillumination is a painless procedure.

2. A nurse is planning care for a hospitalized toddler. To best maintain the toddler's sense of control and security and ease feelings of helplessness and fear, the nurse should perform which action?

• A. Allow the toddler to play with other children in the nursing unit playroom.
• B. Spend as much time as possible with the toddler.
• C. Allow the toddler to select toys from the nursing unit playroom that can be brought into the toddler's hospital room.
• D. Keep hospital routines as similar as possible to those at home.

Correct answer: D

Rationale: The best action for the nurse to take to help a hospitalized toddler maintain a sense of control and security and ease feelings of helplessness and fear is to keep hospital routines as similar as possible to those at home. By incorporating the toddler's usual rituals and routines from home into nursing care activities, the nurse can reduce the stress of hospitalization. This approach gives the toddler a sense of familiarity, control, and security, which can alleviate feelings of helplessness and fear. Allowing the toddler to play with other children in the nursing unit playroom and selecting toys are beneficial activities, but maintaining hospital routines similar to those at home is the most effective way to support the toddler's emotional well-being during hospitalization.

3. Distribution of a drug to various tissues depends on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?

• A. skin
• B. adipose tissue
• C. skeletal muscle
• D. myocardium

Correct answer: D

Rationale: The tissue that would receive the highest amount of cardiac output and thus the highest amount of a drug is the myocardium. Highly perfused tissues include vital organs like the brain, heart, kidneys, adrenal glands, and liver. The myocardium, being part of the heart, receives a significant amount of cardiac output. Choices A (skin) and B (adipose tissue) are poorly perfused tissues and would not receive high amounts of cardiac output. Choice C (skeletal muscle) is also less perfused compared to the myocardium.

4. Which of the following strategies should the nurse include when planning care for children of migrant workers?

• A. Delay immunizations due to acute illness.
• B. Provide parents with copies of medical records.
• C. Offer preventive services during acute illness visits.
• D. Emphasize the importance of having one primary care provider.

Correct answer: B

Rationale: When planning care for children of migrant workers, providing parents with copies of medical records is essential. This helps ensure continuity of care, especially as migrant families may move frequently. Immunizations should not be delayed due to acute illness; preventive care, including immunizations, should be provided even during acute illness visits to ensure the child stays up to date. While it is important to offer preventive services during routine visits, it is not ideal to provide them only during acute illness visits. Emphasizing the importance of having one primary care provider is valuable in healthcare, but it may not be feasible for migrant families due to their mobility.

5. All of the following factors, when identified in the history of a family, are correlated with poverty except:

• A. high infant mortality rate
• B. frequent use of Emergency Departments
• C. consultation with folk healers
• D. low incidence of dental problems

Correct answer: D

Rationale: The correct answer is 'low incidence of dental problems.' Dental problems are prevalent in families living in poverty due to the lack of preventive care and access to dental services. High infant mortality rate is closely correlated with poverty as it reflects various social determinants of health. Families in poverty may resort to frequent use of Emergency Departments due to limited access to primary care. Consulting with folk healers is also common among families in poverty as they might seek alternative and more accessible healthcare options. However, a low incidence of dental problems is less likely in families experiencing poverty.

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