Nursing Elites

1. During an adolescent examination, the nurse asks a 13-year-old female to bend forward at the waist with arms hanging freely. Which of the following assessments is the nurse most likely conducting?

• A. Spinal flexibility
• B. Leg length disparity
• C. Hypostatic blood pressure
• D. Scoliosis

Correct answer: D

Rationale: The correct answer is scoliosis. During the assessment for scoliosis, the nurse asks the adolescent to bend forward at the waist with arms hanging freely to observe for any lateral deviation of the spine, uneven rib levels, or asymmetry. This assessment is a routine part of an adolescent examination, especially in females, as scoliosis is more common in this population. Choices A, B, and C are incorrect. Spinal flexibility is usually assessed through different maneuvers, leg length disparity is evaluated by measuring the length of the legs, and hypostatic blood pressure refers to a decrease in blood pressure due to immobility.

2. The charge nurse is notified that the unit will be receiving an admission of a client from another bed in the hospital in order to make room for others being admitted through the emergency room. The unit is the Women's Health Center of the hospital. Which of the following patients would be most appropriate to be transferred to this unit?

• A. A 26-year-old woman who had a bowel resection
• B. A 40-year-old man who underwent a hernia repair
• C. A 31-year-old woman with septicemia and who is on a ventilator
• D. A 91-year-old man with Alzheimer's disease recovering from a fall

Correct answer: A

Rationale: When deciding on transferring patients between units in a hospital, it is essential to consider the appropriateness of the patient for the receiving unit. The Women's Health Center typically caters to female patients with gynecological or obstetric conditions that do not require intensive monitoring or specialized care. In this scenario, the most suitable patient for transfer to the Women's Health Center would be the 26-year-old woman who had a bowel resection, as her condition aligns more closely with the services provided in that unit. The other options, including a male patient, a critically ill patient on a ventilator, and an elderly patient with Alzheimer's disease, would not be appropriate for transfer to a Women's Health Center due to the specialized care they require, which may not align with the unit's focus and staffing capabilities.

3. The nurse is discussing the need for early diagnosis and treatment of autism spectrum disorder (ASD) with parents of children suspected of having the condition. Which statement should the nurse include?

• A. Early diagnosis and treatment provide the only means for a cure of ASD.
• B. Early diagnosis and treatment gives your child the best chance of becoming a fully functioning adult.
• C. Early diagnosis and treatment provides the best way to ensure that your child can be admitted to an assisted living facility as an adult.
• D. Early diagnosis and treatment prevent your child from developing any other mental condition.

Correct answer: B

Rationale: The correct statement for the nurse to include is that early diagnosis and treatment provide the best chance for the child to become a fully functioning adult. It is important to educate parents that while early intervention can improve outcomes for individuals with ASD, it does not offer a cure but helps in managing symptoms and developing necessary skills. Choice A is incorrect as there is currently no cure for ASD. Choice C is inaccurate as early diagnosis and treatment focus on improving the child's quality of life and independence rather than ensuring admission to an assisted living facility. Choice D is incorrect as early diagnosis and treatment of ASD do not prevent the development of other mental health conditions; however, they can help in identifying and managing such conditions early on.

4. Which of the following conditions may warrant a serum creatinine level?

• A. Rhabdomyolysis
• B. Digitalis toxicity
• C. Glomerulonephritis
• D. All answers are correct

Correct answer: D

Rationale: A serum creatinine level may be warranted in conditions that can affect renal function or cause muscle breakdown. Rhabdomyolysis, characterized by muscle injury and breakdown, can lead to elevated creatinine levels due to the release of creatinine from muscles. Digitalis toxicity can impair renal function, leading to a need for monitoring creatinine levels. Glomerulonephritis, an inflammatory condition affecting the kidney's filtering units, can also impact renal function and require assessment of creatinine levels. Therefore, all the provided conditions may warrant a serum creatinine level to assess renal function and muscle breakdown.

5. What action by the nurse will be most effective in decreasing the spread of pertussis in a community setting?

• A. Providing supportive care to patients diagnosed with pertussis
• B. Teaching family members about the importance of careful handwashing
• C. Teaching patients about the necessity of adult pertussis immunizations
• D. Encouraging patients to complete the prescribed course of antibiotics

Correct answer: C

Rationale: The most effective action by the nurse to decrease the spread of pertussis in a community setting is to teach patients about the necessity of adult pertussis immunizations. The increased rate of pertussis in adults is often attributed to waning immunity after childhood immunization. Immunization is highly effective in protecting communities from infectious diseases. While teaching about handwashing is important for overall infection control, pertussis is primarily spread through respiratory droplets and contact with secretions. Providing supportive care does not significantly impact the disease course or transmission risk. Encouraging completion of antibiotics may help reduce transmission, but patients likely have already spread the disease by the time the diagnosis is made. Therefore, the emphasis should be on prevention through immunization to reduce the spread of pertussis.

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