Nursing Elites

1. During a clinical conference with a group of nursing students, the instructor is describing burn classifications. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?

• A. Skin that is reddened, dry, and slightly swollen
• B. Skin appearing wet with significant pain
• C. Skin with blistering and swelling
• D. Skin that is leathery and dry with some numbness

Correct answer: D

Rationale: Full-thickness burns, also known as third-degree burns, are characterized by a leathery, dry appearance with numbness due to nerve damage. This type of burn extends through all layers of the skin, affecting nerve endings. Choice A describes characteristics of superficial partial-thickness burns, which involve the epidermis and part of the dermis. Choice B describes characteristics of superficial burns, or first-degree burns, which only affect the epidermis. Choice C describes characteristics of superficial to mid-dermal burns, also known as second-degree burns, which involve the epidermis and part of the dermis but do not extend through all skin layers. Therefore, the correct answer is D.

2. An infant is admitted to the neonatal intensive care unit (NICU) with exstrophy of the bladder. What covering should the nurse use to protect the exposed area?

• A. Loose diaper
• B. Dry gauze dressing
• C. Moist sterile dressing
• D. Petroleum jelly gauze pad

Correct answer: C

Rationale: In cases of exstrophy of the bladder, a moist sterile dressing is the most appropriate choice to protect the exposed bladder tissue. Moist sterile dressings help maintain a clean environment, prevent infection, and promote healing. A loose diaper (Choice A) may not provide adequate protection and may lead to contamination. Dry gauze dressing (Choice B) could adhere to the wound and cause trauma upon removal. Petroleum jelly gauze pad (Choice D) is not ideal as it may not provide the necessary barrier against infection and could potentially cause irritation.

3. A healthcare provider is assessing a 2-year-old child with suspected Down syndrome. What characteristic physical feature is the healthcare provider likely to observe?

• A. Epicanthal folds
• B. Webbed neck
• C. Enlarged head
• D. Polydactyly

Correct answer: A

Rationale: Epicanthal folds are a common physical feature seen in individuals with Down syndrome. These are folds of skin that cover the inner corners of the eyes. Webbed neck (Choice B) is associated with Turner syndrome, not Down syndrome. Enlarged head (Choice C) is not a typical physical characteristic of Down syndrome. Polydactyly (Choice D) is the presence of extra fingers or toes, which is not specifically related to Down syndrome.

4. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. Absence of a urethral opening is noted
• B. Penis appears shorter than usual for age
• C. The urethral opening is along the dorsal surface of the penis
• D. The urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: In hypospadias, the urethral opening is located along the ventral surface of the penis. This congenital condition results in the urethral meatus opening on the underside of the penis, rather than at the tip. Choice A is incorrect as there is typically a urethral opening present, though in an abnormal location. Choice B is not a characteristic feature of hypospadias. Choice C is incorrect as the urethral opening in hypospadias is not along the dorsal surface but rather along the ventral surface of the penis.

5. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

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