Nursing Elites

1. Which of the following is the most common type of malignant brain tumor in the United States?

• A. Meningioma
• B. Glioblastoma multiforme
• C. Acoustic neuroma
• D. Pituitary adenoma

Correct answer: B

Rationale: Glioblastoma multiforme is the most common malignant brain tumor in the United States, accounting for a significant portion of cases. It is known for its aggressive nature and poor prognosis. Surgical resection, followed by radiation and chemotherapy, is the standard treatment approach for glioblastoma multiforme. Meningioma, acoustic neuroma, and pituitary adenoma are also types of brain tumors but are not as common as glioblastoma multiforme in the United States.

2. A female patient is prescribed metformin for glucose control. The patient is on NPO status pending a diagnostic test. The nurse is most concerned about which side effect of metformin?

• A. Diarrhea and Vomiting
• B. Dizziness and Drowsiness
• C. Metallic taste
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is 'Hypoglycemia.' When a patient is on NPO status (nothing by mouth) and prescribed metformin, there is an increased risk of hypoglycemia due to the absence of oral intake. Metformin, as an anti-glycemic drug, can lower blood sugar levels, and without food intake, the risk of hypoglycemia is higher. Diarrhea and vomiting are common gastrointestinal side effects of metformin but are not the main concern in this scenario. Dizziness and drowsiness are potential side effects of some medications but are not typically associated with metformin. Metallic taste is a known side effect of metformin but is not the primary concern in this situation where hypoglycemia is more critical to monitor due to the patient's NPO status.

3. Which of the following interventions should the nurse use when working with a Jackson-Pratt drain?

• A. Strip the tubing to remove clots by milking the tubing back toward the client
• B. Empty the drain when the amount of fluid reaches 25 cc
• C. Strip the tubing to remove clots by milking the tubing away from the client
• D. Maintain the level of the drain above the client's incision

Correct answer: C

Rationale: A Jackson-Pratt drain is a type of active wound drain that may be placed following a surgical procedure. This drain actively draws excess blood and fluid out of the wound. If clots develop within the tubing, the nurse should strip the tubing by milking it in a direction away from the client. This action helps to ensure the drain remains patent and effective. Option A is incorrect because the tubing should be milked away from the client, not towards. Option B is incorrect as the drain should be emptied based on the healthcare provider's orders, not at a fixed volume. Option D is incorrect because the level of the drain should be below the level of the incision to allow drainage by gravity.

4. The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention?

• A. Decrease in level of consciousness
• B. Loss of bladder control
• C. Altered sensation to stimuli
• D. Emotional lability

Correct answer: A

Rationale: A decrease in the level of consciousness is a critical finding that would warrant immediate attention in a client post right cerebrovascular accident. This change may indicate an increase in intracranial pressure, leading to inadequate oxygenation of the brain. It could also reveal the presence of a transient ischemic attack, which may signal an impending thrombotic cerebrovascular accident. Loss of bladder control (choice B) can be managed and monitored but does not indicate an immediate threat to the client's life. Altered sensation to stimuli (choice C) can be a concerning finding but may not require immediate attention unless it affects the client's safety. Emotional lability (choice D) may be distressing for the client but does not pose an immediate risk to their health compared to a decrease in the level of consciousness.

5. The parents of a newborn have been told that their child was born with bladder exstrophy, and the parents ask the nurse about this condition. Which explanation, given by the parents, indicates understanding of this condition?

• A. ''It's a hereditary disorder that occurs in every other generation.''
• B. ''It is caused by the use of medications taken by the mother during pregnancy.''
• C. ''It is a condition in which the urinary bladder is abnormally located in the pelvic cavity.''
• D. ''It's an extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall.''

Correct answer: D

Rationale: Bladder exstrophy is a congenital anomaly characterized by the extrusion of the urinary bladder to the outside of the body through a defect in the lower abdominal wall. The cause of bladder exstrophy is not precisely known, but it is believed to be due to a developmental abnormality during embryogenesis. The condition is more common in male newborns. Choice A is incorrect as bladder exstrophy is not a hereditary disorder that occurs in every other generation. Choice B is incorrect as bladder exstrophy is not caused by medications taken by the mother during pregnancy. Choice C is incorrect as it describes the condition inaccurately; it is not just an abnormal location of the bladder in the pelvic cavity, but rather an extrusion of the bladder outside the body through a defect in the lower abdominal wall.

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