Nursing Elites

1. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

2. In a well-child clinic, the nurse examines many children daily. Which of the following toddlers requires further follow-up?

• A. A 13-month-old who is unable to walk
• B. A 20-month-old who is only using 2 and 3 word sentences
• C. A 24-month-old who cries during examination
• D. A 30-month-old who is only drinking from a sip cup

Correct answer: D

Rationale: The correct answer is D because a 30-month-old should have developed the skill to drink from a regular cup by this age. Drinking from a sip cup at this stage may indicate a delay in development. Choices A, B, and C are not as concerning as they can be within the range of normal development. A 13-month-old not walking yet, a 20-month-old using 2 and 3 word sentences, and a 24-month-old crying during examination are all behaviors that can fall within the spectrum of typical development for their respective ages.

3. During a home visit for a family with a new baby, what should the nurse assess first?

• A. feeding patterns
• B. sleeping arrangements
• C. support system
• D. immunization status

Correct answer: A

Rationale: Assessing feeding patterns is the priority during a home visit for a family with a new baby because it is crucial for the health and growth of the newborn. By evaluating the feeding patterns, the nurse can ensure that the baby is receiving adequate nutrition and address any feeding issues promptly. While sleeping arrangements, support system, and immunization status are important aspects to assess during a home visit, they are not as critical as ensuring the newborn's nutritional needs are being met.

4. In the preparation of your health education plan, what is the first thing to do?

• A. Assess community needs for health education
• B. Identify the subjects for health teaching
• C. Specify your goals and objectives
• D. Identify who will provide support and the type of support to be provided

Correct answer: A

Rationale: The correct answer is A: Assess community needs for health education. This is the initial step in developing a health education plan as it helps in understanding the specific requirements of the community. Identifying subjects for teaching (choice B) comes after assessing needs. Specifying goals and objectives (choice C) is crucial but typically follows the assessment of community needs. Identifying support providers and types (choice D) is important but is not the first step in preparing a health education plan.

5. A pre-term baby develops nasal flaring, cyanosis, and diminished breath sounds on one side. The provider's diagnosis is spontaneous pneumothorax. Which procedure should the nurse prepare for first?

• A. Cardiopulmonary resuscitation
• B. Insertion of a chest tube
• C. Oxygen therapy
• D. Assisted ventilation

Correct answer: B

Rationale: The correct answer is B: Insertion of a chest tube. In a case of spontaneous pneumothorax, the primary intervention is to insert a chest tube. This procedure allows the trapped air to escape from the pleural space, relieving pressure and enabling the lung to re-expand. Choices A, C, and D are not the initial interventions for spontaneous pneumothorax. Cardiopulmonary resuscitation is indicated for cardiac arrest, oxygen therapy may provide supportive care but does not address the underlying issue of trapped air in the pleural space, and assisted ventilation may be needed later but is not the first-line treatment for a pneumothorax.

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