Nursing Elites

1. The mother of a 2-month-old infant brings the child to the clinic for a well-baby check. She is concerned because she feels only one testis in the scrotal sac. Which of the following statements about the undescended testis is the most accurate?

• A. Normally, the testes descend by one year of age.
• B. The infant will likely require surgical intervention.
• C. The infant likely has only one testis.
• D. Normally, the testes are descended by birth.

Correct answer: A

Rationale: The correct answer is that normally, the testes descend by one year of age. In young infants, it is common for the testes to retract into the inguinal canal when the environment is cold or the cremasteric reflex is stimulated. The exam should be done in a warm room with warm hands. It is most likely that both testes are present and will descend by a year. Option B is incorrect as not all cases of undescended testes require surgical intervention. Option C is incorrect because feeling only one testis does not necessarily mean the infant only has one testis. Option D is inaccurate as the testes do not normally descend by birth, but rather by one year of age. If the testes do not descend by one year, a full assessment will be needed to determine the appropriate treatment.

2. A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

• A. MS symptoms may be worse after the pregnancy
• B. Women with MS frequently have premature labor
• C. MS is associated with an increased risk for congenital defects
• D. Symptoms of MS are likely to become worse during pregnancy

Correct answer: A

Rationale: After pregnancy, women with MS are at higher risk for exacerbation of symptoms due to the postpartum period. There is no increased risk for congenital defects in infants born to mothers with MS. Symptoms of MS may actually improve during pregnancy, likely due to hormonal changes. MS does not significantly impact the onset of labor. Therefore, the correct response is that MS symptoms may worsen after pregnancy, making option A the accurate answer. Options B, C, and D are incorrect as they do not accurately reflect the risks associated with pregnancy in individuals with MS.

3. Which is a physical, integumentary risk among the elderly population?

• A. Skin tears
• B. Thickened skin
• C. Thinning toe nails
• D. Less nasal hair

Correct answer: A

Rationale: Skin tears are a physical integumentary risk among the elderly population. As individuals age, their skin becomes thinner and more fragile, making them susceptible to skin tears. Thickened skin, thinning toenails, and reduced nasal hair are common age-related changes but do not pose the same level of risk as skin tears. Thickened skin may provide some protection, thinning toenails are primarily a cosmetic concern, and reduced nasal hair does not typically lead to significant health risks.

4. A nurse is assigned to care for a deaf client. During her lunch hour, she visits the hospital library and reads more about deaf culture in order to better provide appropriate care for her client. This action is an example of:

• A. Cultural knowledge
• B. Cultural noise
• C. Cultural diversity
• D. Cultural divide

Correct answer: A

Rationale: Cultural knowledge involves seeking information and educating oneself about different cultural groups. In this scenario, the nurse is demonstrating cultural knowledge by learning more about deaf culture to improve the care provided to the deaf client. This proactive approach helps in understanding the client's background, beliefs, and communication preferences, leading to better outcomes. 'Cultural noise' and 'Cultural divide' are incorrect as they do not reflect the nurse's positive action of seeking knowledge to enhance care. 'Cultural diversity' is also incorrect as it does not accurately describe the nurse's specific action of acquiring knowledge about a particular culture.

5. The client with multiple sclerosis is being educated by the nurse on exercises and physical activities. Which statement by the client indicates a need for further teaching?

• A. "I can lift weights and engage in resistance training."?
• B. "I should exercise until I am exhausted."?
• C. "I can incorporate aerobic exercises into my routine."?
• D. "I should perform proper stretching before starting my routine."?

Correct answer: B

Rationale: The correct answer is, "I should exercise until I am exhausted."? This statement indicates a need for further teaching because patients with multiple sclerosis should avoid exercising to the point of exhaustion or fatigue. Strenuous physical activity can increase body temperature and potentially worsen symptoms in individuals with multiple sclerosis. Choice A is correct because lifting weights and resistance training can be appropriate exercises for patients with multiple sclerosis. Choice C is valid because aerobic exercises can also be beneficial. Choice D is accurate as proper stretching before starting an exercise routine is essential for preventing injuries.

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