Nursing Elites

1. A nurse is assisting with data collection regarding skin and peripheral vascular findings on a client in later adulthood. Which observation would the nurse expect to note as an age-related finding?

• A. Thin, ridged toenails
• B. Thick skin on the lower legs
• C. Loss of hair on the lower legs
• D. Bounding dorsalis pedis pulse

Correct answer: C

Rationale: In later adulthood, age-related findings include trophic changes associated with arterial insufficiency, such as thin, shiny skin; thin, ridged toenails; and loss of hair on the lower legs. These changes occur normally with aging. Thick skin on the lower legs would not be an expected age-related finding as it typically indicates chronic venous insufficiency. A bounding dorsalis pedis pulse is not typical in later adulthood and may indicate arterial insufficiency, which is not an age-related finding.

2. The nurse is assessing the dental status of an 18-month-old child. How many teeth should the nurse expect to examine?

• A. 6
• B. 8
• C. 12
• D. 16

Correct answer: C

Rationale: An 18-month-old child should have approximately 12 teeth. Children typically start getting teeth around 6 months of age. By subtracting 6 from the number of months in the child's age, you can calculate the expected number of teeth. For an 18-month-old child, 18 - 6 = 12 teeth. Therefore, the correct answer is 12 teeth. Choices A, B, and D are incorrect because they do not align with the expected dental development in an 18-month-old child.

3. The LPN is taking care of a client with a documented allergy to Penicillin. After rounds, the LPN notices that the client has an order for Cefazolin. Which of the following actions would be the least appropriate?

• A. The LPN clarifies the severity of the Penicillin allergy.
• B. The LPN discusses the order with the care team prior to administering Cefazolin.
• C. The LPN administers all ordered medications except for the Cefazolin.
• D. The LPN monitors the client after a test dose of Cefazolin is administered.

Correct answer: C

Rationale: The least appropriate action is for the LPN to administer all ordered medications except for the Cefazolin. The LPN should always consider the client's documented allergy to Penicillin seriously. It is crucial to discuss the order with the care team before administering Cefazolin to ensure patient safety. Administering a medication that could potentially cause harm due to a documented allergy is unsafe practice. While monitoring the client after a test dose of Cefazolin is important, it should not precede clarification with the care team regarding the allergy and the appropriateness of the medication. Therefore, withholding the Cefazolin is the most appropriate action in this scenario.

4. According to Erik Erikson's developmental theory, which choice is a developmental task of the middle adult?

• A. Redefining self-perception and capacity for intimacy
• B. Making decisions concerning career, marriage, and parenthood
• C. Providing guidance during interactions with his children
• D. Verbalizing readiness to assume parental responsibilities

Correct answer: C

Rationale: According to Erikson's developmental theory, the primary developmental task of the middle adult is to achieve generativity. Generativity is the willingness to care for and guide others. Middle adults can achieve generativity with their own children or the children of close friends or through guidance in social interactions with the next generation. Providing guidance during interactions with his children aligns with this developmental task. Choices A, B, and D are not specific to the middle adult stage as they are tasks associated with young adults. Redefining self-perception and capacity for intimacy, making decisions concerning career, marriage, and parenthood, and verbalizing readiness to assume parental responsibilities are all developmental tasks of the young adult according to Erikson's theory.

5. A nurse is telling a pregnant client about the signs that must be reported to the health care provider. The nurse tells the client that the health care provider should be contacted if which occurs?

• A. Puffiness of the face
• B. Breast tenderness
• C. Morning sickness
• D. Urinary frequency

Correct answer: A

Rationale: During pregnancy, it is important to be aware of danger signs that warrant contacting the healthcare provider. Puffiness of the face, especially around the eyes, can indicate a serious condition like preeclampsia. Other danger signs include vaginal bleeding, rupture of membranes, severe abdominal pain, visual disturbances, persistent vomiting, and changes in fetal movements. Morning sickness, breast tenderness, and urinary frequency are common symptoms of pregnancy and are not typically concerning unless they become severe or persistent, and do not usually require immediate medical attention.

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