Nursing Elites

1. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?

• A. HR of 60 bpm
• B. BP of 160/88
• C. Discolored urine
• D. Inspiratory wheezing

Correct answer: C

Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.

2. Which statement fosters cultural competence?

• A. Treat everyone the same regardless of their culture
• B. Provide an outline of your beliefs as a starting point
• C. Acknowledge and respond to influences of cultural beliefs in the intervention plan
• D. Ask the family to outline how their beliefs will influence therapy

Correct answer: C

Rationale: Cultural competence involves recognizing and considering the impact of cultural beliefs on individuals. By acknowledging and responding to these cultural influences in the intervention plan, professionals can tailor their approach effectively and respectfully. This approach helps build trust, enhances communication, and improves outcomes in culturally diverse settings.

3. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?

• A. Bag-valve-mask system
• B. Sterile gauze and saline
• C. Soft arm restraints
• D. Endotracheal tube

Correct answer: D

Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.

4. A patient with Parkinson�s disease who takes levodopa/carbidopa (Sinemet) comes to the clinic for a semi-annual physical examination. Which question is the most important for that nurse to ask?

• A. Have you noticed any swelling in your feet?
• B. Are you having vivid dreams or hallucination?
• C. Have you noticed any changes in your stool?
• D. Have you had your flu vaccine?

Correct answer: B

Rationale: Patients taking levodopa/carbidopa (Sinemet) are at increased risk for the psychiatric side effects of levodopa, including visual hallucinations, vivid dreams, nightmares, and paranoid ideation. The other questions are not directly related to problems that are likely to occur with this drug.

5. When evaluating infants and young children in early intervention services, which of the following is recommended?

• A. Gain information from family, caregivers, professionals, and the child to create a total picture of the child's strengths and challenges
• B. Report test scores and therapist observations rather than parent reports
• C. Identify the areas of concern, weaknesses, and deficits to best address the child's and family's needs
• D. Observe the child in one setting with objective data from professionals

Correct answer: A

Rationale: When evaluating infants and young children in early intervention services, it is crucial to gather information from multiple sources, including family, caregivers, professionals, and the child. This holistic approach helps create a comprehensive understanding of the child's strengths and challenges, leading to a more effective intervention plan.

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