Nursing Elites

1. The mother of a newborn who was circumcised before discharge from the hospital calls the nurse at the pediatrician's office and tells the nurse that she is concerned because she has noticed a yellow crust over the circumcision site. The nurse provides which information to the mother?

• A. That it could indicate a sign of an infection and the infant's temperature should be checked every 2 hours
• B. That the crust is to be expected as a normal part of healing
• C. To bring the infant to the pediatrician's office to be checked
• D. To remove the crust, using a warm, wet face cloth and a mild soap

Correct answer: B

Rationale: After circumcision, a yellow crust may form over the circumcision site, which is a normal part of healing and should not be removed. The mother should be reassured that this crust is to be expected. Yellow crusting or discharge is not indicative of an infection, and there is no need to notify the pediatrician. Checking the infant's temperature every 2 hours is unnecessary and may cause unnecessary alarm to the mother.

2. A patient reports, "I tore 3 of my 4 Rotator cuff muscles in the past."? Which of the following muscles cannot be considered as possibly being torn?

• A. Teres minor
• B. Teres major
• C. Supraspinatus
• D. Infraspinatus

Correct answer: B

Rationale: The correct answer is Teres major. The Rotator Cuff consists of Teres Minor, Infraspinatus, Supraspinatus, and Subscapularis muscles, not Teres major. Teres major is not part of the rotator cuff, so it cannot be considered as possibly being torn. The other choices, Teres minor, Supraspinatus, and Infraspinatus, are all part of the Rotator Cuff and could potentially be torn in this patient's case.

3. Following a classic cholecystectomy resection for multiple stones, the PACU nurse observes serosanguinous drainage on the dressing. The most appropriate intervention is to:

• A. notify the physician of the drainage
• B. change the dressing
• C. reinforce the dressing
• D. apply an abdominal binder

Correct answer: C

Rationale: In the context of a classic cholecystectomy resection, serosanguinous drainage is an expected finding postoperatively due to the nature of the surgery. The appropriate intervention in this situation is to reinforce the dressing. Changing the dressing prematurely can increase the risk of introducing infection. Applying an abdominal binder is not recommended as it can obstruct the visualization of the dressing and the underlying wound, making it difficult to monitor for any complications or changes in drainage. Notifying the physician may be necessary if there are significant changes in the drainage characteristics or other concerning signs, but the immediate action should be to reinforce the dressing to maintain a clean and secure environment for wound healing.

4. Which of the following foods is a complete protein?

• A. corn
• B. eggs
• C. peanuts
• D. sunflower seeds

Correct answer: B

Rationale: Eggs are considered a complete protein because they contain all nine essential amino acids required by the human body. In contrast, corn, peanuts, and sunflower seeds are incomplete proteins as they lack one or more essential amino acids. Corn, although a staple food for many cultures, is deficient in the amino acids lysine and tryptophan. Peanuts are low in the amino acid methionine, and sunflower seeds are low in lysine. Therefore, eggs are the correct answer as a complete protein source.

5. When working with multicultural populations, the nurse should consider all of the following when planning care for a client with an altered sexuality pattern except:

• A. some Hispanic and Native-American cultures are very open when discussing sexuality.
• B. some cultures view the postpartum period as a state of impurity.
• C. some women in the African-American culture view childbearing as a validation of their femaleness.
• D. some Native-American women believe monthly menstruation maintains physical well-being and harmony.

Correct answer: A

Rationale: When working with multicultural populations, it is essential to understand cultural variations in beliefs and practices related to sexuality. While it is true that some cultures view the postpartum period as a state of impurity and that some women in the African-American culture view childbearing as a validation of their femaleness, the statement 'some Hispanic and Native-American cultures are very open when discussing sexuality' is incorrect. In reality, many cultures, including Hispanic and Native-American cultures, are sometimes hesitant to discuss sexuality. For example, some Navajos, Hispanics, and Orthodox Jews may consider the postpartum period as impure, leading to seclusion of women until the end of bleeding, marked by a ritual bath. Additionally, many Native-American women believe in the importance of monthly menstruation for physical well-being and harmony. Therefore, the statement about Hispanic and Native-American cultures being very open about discussing sexuality is not accurate in the context of working with multicultural populations.

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