Nursing Elites

1. A patient is admitted and complains of gastric pain, fever, and diarrhea. Which assessment finding should be reported to the healthcare provider immediately?

• A. Abdominal distention
• B. A bruit near the epigastric area
• C. 3 episodes of vomiting in the last hour
• D. Blood pressure of 160/90

Correct answer: B

Rationale: A bruit near the epigastric area may indicate the presence of an aortic aneurysm, which is a life-threatening condition requiring immediate medical attention. Abdominal distention, while concerning, may not be as urgent as a potential aneurysm. Vomiting episodes may suggest underlying issues but do not present an immediate life-threatening situation. A blood pressure of 160/90, though elevated, does not pose the same level of immediate threat as a potential aortic aneurysm.

2. The nurse reviews the record of a child who is suspected to have glomerulonephritis and expects to note which finding that is associated with this diagnosis?

• A. Hypotension
• B. Brown-colored urine
• C. Low urinary specific gravity
• D. Low blood urea nitrogen level

Correct answer: B

Rationale: Glomerulonephritis refers to a group of kidney disorders characterized by inflammatory injury in the glomerulus. Gross hematuria resulting in dark, smoky, cola-colored, or brown-colored urine is a classic symptom of glomerulonephritis. Hypertension is also common. Blood urea nitrogen levels may be elevated. A moderately elevated to high urinary specific gravity is associated with glomerulonephritis.

3. A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

• A. IgA
• B. IgD
• C. IgE
• D. IgG

Correct answer: D

Rationale: IgG is the only immunoglobulin that can cross the placental barrier, providing passive immunity to the fetus. About 70-80% of the immunoglobulins in the blood are IgG. Specific IgG antibodies are generated after an initial exposure to an antigen, offering long-term protection against microorganisms. IgG antibodies are critical for protecting the fetus as they can be rapidly reproduced upon re-exposure to the same antigen. IgA is primarily found in mucosal areas, IgD is involved in antigen recognition, and IgE is associated with allergic reactions, but they do not provide the same level of protection to the fetus as IgG.

4. The mother of a child who had a cleft palate repair 4 days ago is receiving home care instructions. Which statement by the mother indicates the need for further instruction?

• A. ''I will use a short nipple on the bottle.''
• B. ''I should avoid using straws for drinking.''
• C. ''I can give my child the pacifier in 2 weeks.''
• D. ''I may give my baby food mixed with water.''

Correct answer: B

Rationale: The correct answer is ''I should avoid using straws for drinking.'' After a cleft palate repair, the child should avoid straws, pacifiers, spoons, and fingers near the mouth for 7 to 10 days to prevent injury to the surgical site. Allowing the child to use a straw can create negative pressure in the mouth, potentially disrupting the healing process. The other options are appropriate postoperative instructions for a child who had a cleft palate repair and do not pose a risk to the surgical site.

5. A client presents with symptoms of a sore throat, swollen lymph nodes in the neck, fever, chills, and extreme fatigue. Based on these symptoms, which of the following illnesses could the nurse consider for this client?

• A. Methicillin-resistant Staphylococcus aureus (MRSA)
• B. Hepatitis B
• C. Infectious mononucleosis
• D. Norovirus infection

Correct answer: C

Rationale: Infectious mononucleosis is a viral disease caused by the Epstein-Barr virus. The symptoms of sore throat, fever, chills, swollen lymph nodes, and extreme fatigue are characteristic of infectious mononucleosis. The diagnosis is confirmed through the client's history and blood tests for the Epstein-Barr virus. Methicillin-resistant Staphylococcus aureus (MRSA) presents with localized skin infections, not the systemic symptoms described. Hepatitis B typically presents with jaundice, abdominal pain, and liver inflammation, not the symptoms described. Norovirus infection commonly causes gastrointestinal symptoms like vomiting and diarrhea, not the symptoms presented by the client.

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