Nursing Elites

1. The nurse in the pediatric clinic performs a physical assessment of a 13-year-old boy. Which of the following findings by the nurse requires an immediate intervention?

• A. The adolescent complains of his scrotum aching after exercise. The nurse palpates a worm-like mass above the testes
• B. The nurse noted unilateral breast enlargement
• C. The child’s scrotum appears swollen, and a soft mass is palpated. The nurse is unable to insert a finger above the mass
• D. The child’s scrotum appears enlarged and red. The nurse palpated a thickened and swollen spermatic cord.

Correct answer: D

Rationale: A swollen and thickened spermatic cord could indicate testicular torsion, which is a surgical emergency.

2. When does the nurse act as a client advocate?

• A. Pulling the curtain around the client's bed while changing a dressing
• B. Contacting the health care provider to request a meeting for the client
• C. Ensuring access to medical information by appropriate personnel only
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Acting as a client advocate involves various actions to protect the client's rights and well-being. Pulling the curtain around the client's bed while changing a dressing ensures privacy and dignity. Contacting the health care provider to request a meeting for the client facilitates communication and addresses the client's needs. Ensuring access to medical information by appropriate personnel only safeguards the client's confidentiality and privacy. Therefore, all the actions mentioned in choices A, B, and C are examples of a nurse acting as a client advocate, making D the correct answer.

3. Which drugs contribute to peptic ulcers?

• A. Antacids
• B. Certain antibiotics
• C. Cholesterol-lowering medications
• D. Nonsteroidal anti-inflammatory drugs

Correct answer: D

Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to contribute to the development of peptic ulcers by affecting the protective lining of the stomach and increasing stomach acid production. This can lead to irritation and ulcer formation. Antacids are actually used to relieve symptoms of peptic ulcers by neutralizing stomach acid. Certain antibiotics may be prescribed to treat H. pylori infection, a common cause of peptic ulcers. Cholesterol-lowering medications are not typically associated with causing peptic ulcers.

4. A nurse is reviewing the laboratory results for a client with a history of atherosclerosis and notes elevated cholesterol levels. Which statement by the client indicates the nurse should plan follow-up instruction on a low-cholesterol diet?

• A. ''I take an omega-3 supplement daily.''
• B. ''I cook my food with canola oil.''
• C. ''I eat three eggs for breakfast each morning.''
• D. ''I flavor my meat with lemon juice.''

Correct answer: C

Rationale: The correct answer is C. Eating three eggs daily increases cholesterol intake, which could exacerbate atherosclerosis. Choice A is incorrect because taking an omega-3 supplement can actually help reduce cholesterol levels. Choice B is incorrect as canola oil is a healthier choice compared to saturated fats. Choice D is incorrect since flavoring meat with lemon juice does not significantly impact cholesterol levels.

5. When measuring the leg circumference of a client with bipedal edema, what position is best to ensure accurate measurements?

• A. Dorsal recumbent
• B. Sitting
• C. Standing
• D. Supine

Correct answer: A

Rationale: When measuring the leg circumference of a client with bipedal edema, the best position to ensure accurate and consistent measurements is the dorsal recumbent position. This position allows the legs to be positioned comfortably, and the individual is lying on their back with legs extended, facilitating accurate measurement of the circumference without the influence of gravity. Sitting, standing, and supine positions may not provide optimal conditions for accurate leg circumference measurements, particularly in clients with bipedal edema where positioning and consistency are crucial. Sitting and standing positions may not allow for consistent leg positioning and could introduce errors due to the effects of gravity on the fluid distribution. The supine position, while similar to dorsal recumbent, may not be as comfortable for the client and could still be influenced by gravity when measuring leg circumference.

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