Nursing Elites

1. Select the criteria that is accurately paired with its indication of birth weight or gestational age.

• A. Low birth weight: The neonate's weight is less than 1,500 g at the time of delivery.
• B. Appropriate for gestational age: The neonate's weight ranges from the 10th to the 90th percentile.
• C. Large for gestational age: The neonate's weight is above the 99th percentile.
• D. Small for gestational age: The neonate's weight is below the 20th percentile.

Correct answer: B

Rationale: Appropriate for gestational age (AGA) indicates a neonate's weight ranging from the 10th to the 90th percentile. This range signifies that the baby's weight is within the normal range for their gestational age. Choices A, C, and D provide inaccurate information about the criteria and do not correctly correspond to the indicated birth weight or gestational age. Low birth weight typically refers to a weight below 2,500 g, large for gestational age above the 90th percentile, and small for gestational age below the 10th percentile.

2. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

3. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

4. Which statement about glaucoma is true and accurate?

• A. Acute angle-closure glaucoma is an ocular emergency.
• B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision.
• C. Primary open-angle glaucoma leads to eye pain, nausea, and vomiting, blurry vision, and halos.
• D. Bubbles are implanted to protect the retina from glaucoma.

Correct answer: A

Rationale: The correct answer is A: 'Acute angle-closure glaucoma is an ocular emergency.' Acute angle-closure glaucoma is indeed considered an ocular emergency that requires immediate attention to prevent vision loss. Choice B is incorrect because acute angle-closure glaucoma commonly presents with symptoms like severe eye pain, headache, blurred vision, and halos around lights. Choice C is incorrect as these symptoms are more indicative of acute angle-closure glaucoma rather than primary open-angle glaucoma. Choice D is incorrect since bubbles are not typically used to protect the retina from glaucoma; treatment usually involves medications, laser therapy, or surgery to manage intraocular pressure.

5. A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

• A. I hope I can adjust to using crutches while I am recovering.
• B. I am worried about taking care of my toddler at home.
• C. I just don't think I can handle looking at my leg.
• D. I am not sure how I will pay for all the therapy I will need.

Correct answer: A

Rationale: The client's statement about adjusting to using crutches while recovering suggests a potential need for occupational therapy referral. Occupational therapists assist individuals in regaining independence in activities of daily living, including mobility aids and adaptations. Choices B, C, and D are more indicative of emotional or financial concerns and may require referrals to other healthcare professionals like counselors or financial advisors, rather than occupational therapists.

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