Nursing Elites

1. A patient is suspected to have sustained a spinal cord injury. What best describes the overarching principles used to guide the care for this type of condition?

• A. Immobilize the cervical area to prevent further injury
• B. Monitor the patient's level of consciousness to prevent neurologic deterioration
• C. Help the patient with activities of daily living and provide emotional and physical support to help them adjust to their injury
• D. Facilitate tissue perfusion to the spinal cord while maintaining airway and breathing

Correct answer: D

Rationale: The correct answer is to facilitate tissue perfusion to the spinal cord while maintaining airway and breathing. In the acute phase of a spinal cord injury, ensuring proper tissue perfusion to the spinal cord is crucial to prevent further damage. Maintaining airway, breathing, and circulation is essential in guiding the overall care for a patient with a spinal cord injury. Choices A, B, and C, while important in certain aspects of care, are not the overarching principles that guide the immediate management of a suspected spinal cord injury.

2. Which patient poses the least infection risk to an immunosuppressed patient who had a liver transplant?

• A. The patient with chronic pancreatitis
• B. The patient currently infected with a respiratory virus
• C. The patient with a healing leg wound
• D. The patient with a urinary tract infection

Correct answer: C

Rationale: The patient with a healing leg wound poses the least infection risk to an immunosuppressed patient who had a liver transplant. Chronic pancreatitis can lead to complications such as infections that can pose a risk to immunosuppressed individuals. Patients infected with respiratory viruses or urinary tract infections are actively infectious, which can put immunosuppressed patients at a higher risk of acquiring infections. Therefore, the patient with a healing leg wound is the least likely to pose an immediate infection risk.

3. When is cleft palate repair usually performed in children?

• A. A cleft palate cannot be repaired in children.
• B. Repair is usually performed by age 8 weeks.
• C. Repair is usually performed by 2 months of age.
• D. Repair is usually performed between 6 months and 2 years.

Correct answer: D

Rationale: Cleft palate repair timing is individualized based on the severity of the deformity and the child's size. Typically, cleft palate repair is performed between 6 months and 2 years of age. This age range allows for optimal outcomes and is often done before 12 months to promote normal speech development. Early closure of the cleft palate helps to facilitate speech development. Options A, B, and C are incorrect because a cleft palate can be repaired in children, and repair is usually performed between 6 months and 2 years of age, not at 8 weeks or 2 months.

4. Your patient has been diagnosed with acute bronchitis. You should expect that all of the following will be ordered EXCEPT:

• A. Increased fluid intake
• B. Cough medications
• C. Antibiotics
• D. Use of a vaporizer

Correct answer: C

Rationale: In the management of acute bronchitis, antibiotics are not typically prescribed unless there is a confirmed bacterial infection. Acute bronchitis is usually caused by a virus, so antibiotics are not effective in treating it. The primary focus is on symptom management and supportive care. Increased fluid intake helps keep the airway moist and liquefy secretions, aiding in their removal. Cough medications can help relieve cough symptoms. The use of a vaporizer can help moisten the air, making breathing more comfortable for the patient. It is crucial to differentiate between viral and bacterial causes of respiratory infections to avoid unnecessary antibiotic use and prevent antibiotic resistance. Therefore, the correct answer is 'Antibiotics.' Increased fluid intake, cough medications, and the use of a vaporizer are commonly recommended for managing symptoms and improving comfort in patients with acute bronchitis.

5. Which of the following can cause coup-contrecoup injuries?

• A. Rotational forces
• B. Deformation forces
• C. Deceleration forces
• D. Acceleration forces

Correct answer: C

Rationale: Deceleration forces occur when the head is moving and abruptly comes to a stop, such as in a car crash. This sudden deceleration can cause the brain to hit against the skull, resulting in coup-contrecoup injuries. In a coup-contrecoup injury, the brain is damaged on opposite sides due to the initial impact and the rebound effect inside the skull. Rotational forces usually result in diffuse axonal injuries rather than coup-contrecoup injuries. Deformation forces can cause focal brain injuries but not coup-contrecoup injuries. Acceleration forces typically lead to diffuse brain injuries, not coup-contrecoup injuries. Therefore, the correct answer is deceleration forces.

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