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. In managing cystic fibrosis, which nutrition therapy is crucial for patients with pancreatic insufficiency?

• A. A low-fat diet to prevent steatorrhea
• B. A low-sodium diet to normalize fluid status
• C. A high-fiber diet to normalize bowel function
• D. Pancreatic enzyme replacement therapy to help digestion

Correct answer: D

Rationale: In cystic fibrosis patients with pancreatic insufficiency, pancreatic enzyme replacement therapy is vital for aiding digestion. This therapy helps compensate for the decreased production of digestive enzymes by the pancreas, enabling the proper breakdown and absorption of nutrients. Options A, B, and C are not the primary focus of nutrition therapy for cystic fibrosis patients with pancreatic insufficiency.

3. Which hospital level is a 296-bed facility that is staffed and equipped to provide care for all categories of patients?

• A. FSB
• B. CSH
• C. GH
• D. FH

Correct answer: C

Rationale: The correct answer is "GH" (General Hospital), which is a 296-bed facility providing comprehensive care for all categories of patients. Choice A, FSB, is incorrect as it does not denote a hospital level. Choice B, CSH, is incorrect as it does not specify a 296-bed facility. Choice D, FH, is incorrect as it does not indicate a hospital level or capacity.

4. A patient with a history of gout should avoid which type of food?

• A. Red meat
• B. Chicken
• C. Fish
• D. Dairy

Correct answer: A

Rationale: A patient with a history of gout should avoid foods high in purines, which can exacerbate gout attacks. Red meat is particularly high in purines, so it is the type of food that should be avoided. Chicken and fish are lower in purines compared to red meat, making them better choices for individuals with gout. Dairy products are generally not associated with triggering gout attacks, so they can be consumed in moderation by patients with gout.

5. The nurse is preparing a teaching care plan for the client diagnosed with nephritic syndrome. Which intervention should the nurse include?

• A. Discontinue the use of steroid therapy immediately if symptoms develop.
• B. Take diuretics as needed to treat the dependent edema in ankles.
• C. Increase the intake of dietary sodium every day to decrease fluid retention.
• D. Report any decrease in daily weight during treatment to the healthcare provider.

Correct answer: D

Rationale: The correct answer is D. Reporting a decrease in daily weight is crucial when managing nephritic syndrome as it can indicate worsening of the condition or dehydration. It is essential to monitor weight changes closely to assess the effectiveness of treatment and the client's fluid status. Choice A is incorrect because discontinuing steroid therapy abruptly can lead to complications; gradual tapering is usually recommended. Choice B is incorrect as diuretics should be taken as prescribed by the healthcare provider to manage fluid retention. Choice C is also incorrect because increasing dietary sodium can exacerbate fluid retention, which is counterproductive in nephritic syndrome.

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