Nursing Elites

1. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. absence of a urethral opening
• B. penis appears shorter than usual for age
• C. the urethral opening is along the dorsal surface of the penis
• D. the urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: Hypospadias is a congenital condition where the urethral opening is located along the ventral surface of the penis, not the dorsal surface (Choice C) or absent (Choice A). This leads to the characteristic appearance of a ventrally displaced urethral meatus. The penis may appear normal in size but with the urethral opening positioned abnormally (Choice D), rather than being shorter than usual (Choice B). Therefore, the correct expectation for a newborn with hypospadias is that the urethral opening is along the ventral surface of the penis, making Choice D the correct answer.

2. A parent tells the nurse in the emergency department, 'My 3-year-old has had a fever for several days and has been vomiting.' After instituting ordered measures to reduce the fever, what nursing action is most important?

• A. Preventing shivering
• B. Restricting oral fluids
• C. Measuring output hourly
• D. Taking vital signs hourly

Correct answer: A

Rationale: Preventing shivering is crucial in this scenario as it can increase body temperature and counteract the effects of antipyretic measures aimed at reducing the fever. Shivering generates heat through muscle activity, which can elevate the body temperature. Restricting oral fluids (choice B) is inappropriate as maintaining hydration is vital, especially in cases of fever and vomiting. Measuring output hourly (choice C) and taking vital signs hourly (choice D) are important nursing actions but not the most critical in this case where preventing shivering takes precedence.

3. A nurse is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the nurse likely to observe?

• A. Projectile vomiting
• B. Diarrhea
• C. Constipation
• D. Abdominal distension

Correct answer: A

Rationale: Projectile vomiting is the hallmark clinical manifestation of pyloric stenosis in infants. In pyloric stenosis, the muscle surrounding the opening between the stomach and the small intestine thickens, leading to obstruction. This obstruction causes forceful, projectile vomiting, which is typically non-bilious (does not contain bile) and occurs after feedings. Choices B, C, and D are incorrect because diarrhea, constipation, and abdominal distension are not typical symptoms of pyloric stenosis.

4. The instructor is educating a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?

• A. Myelination continues into adolescence.
• B. The process occurs in a head-to-toe fashion.
• C. Myelination speeds up nerve impulses.
• D. Myelination increases the specificity and efficiency of nerve impulses.

Correct answer: B

Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect because myelination continues beyond 4 years of age and into adolescence. Choice C is incorrect as myelination speeds up nerve impulses rather than slowing them down. Choice D is incorrect because myelination increases the specificity and efficiency of nerve impulses, making them more focused and precise.

5. An instructor is developing a plan for a class of nursing students on various skin disorders. When describing urticaria, what would the instructor include?

• A. It is a type IV hypersensitivity reaction.
• B. Histamine release leads to vasodilation.
• C. Wheals appear first followed by erythema.
• D. The nonpruritic rash blanches with pressure.

Correct answer: B

Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction, not type IV. When triggered, histamine release leads to vasodilation, causing characteristic wheals. Wheals are typically followed by erythema. The rash in urticaria is pruritic and does blanch with pressure, unlike the nonpruritic rash described in choice D. Therefore, the most appropriate description of urticaria includes histamine release and vasodilation, as stated in choice B.

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