Nursing Elites

1. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

• A. To check for unusual discharges from the breast
• B. To check for any obvious malignancy
• C. To observe the size and contour of the breast
• D. To check for thickness and lumps in the breast

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

2. Which cells in the islet of the pancreas are responsible for synthesizing insulin?

• A. Alpha cells
• B. Beta cells
• C. Gamma cells
• D. Delta cells

Correct answer: B

Rationale: Beta cells in the islets of Langerhans in the pancreas are responsible for the production and secretion of insulin, which is crucial for regulating blood glucose levels. Alpha cells, on the other hand, produce glucagon, a hormone that raises blood glucose levels. Gamma cells and Delta cells do not exist in the islets of Langerhans; therefore, they are incorrect choices.

3. A healthcare professional is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL indicates fluid volume excess in a client with heart failure. BUN (Blood Urea Nitrogen) levels can be low in fluid overload due to hemodilution, a common occurrence in heart failure. High levels of BUN usually indicate dehydration or impaired renal function, which are not the case in fluid volume excess. Choices B, C, and D are within normal ranges and do not specifically indicate fluid volume excess.

4. You are to apply a transdermal patch of nitoglycerin to your client. The following are important guidelines to observe EXCEPT:

• A. Apply to hairless clean area of the skin not subject to much wrinkling
• B. Patches may be applied to distal part of the extremities like forearm
• C. Change application and site regularly to prevent irritation of the skin
• D. Wear gloves to avoid any medication on your hand

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Before administration of blood and blood products, the nurse should first:

• A. Check with another R.N the client’s name, Identification number, ABO and RH type.
• B. Explain the procedure to the client
• C. Assess baseline vital signs of the client
• D. Check for the BT order

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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