Nursing Elites

1. The UAP is caring for a male resident of a long-term care facility who has an external urinary catheter. Which finding should the PN instruct the UAP to report immediately?

• A. Swollen and discolored penile shaft
• B. Prepuce extends over the head of the penis
• C. Leaking urine around the top of the catheter
• D. Moist and excoriated perineal skin folds

Correct answer: A

Rationale: The correct answer is A: Swollen and discolored penile shaft. Swelling and discoloration of the penile shaft may indicate an infection or other complications requiring immediate attention. Prompt reporting allows for timely intervention to prevent further harm to the client. Choice B is incorrect because the prepuce extending over the head of the penis is not an urgent issue. Choice C, leaking urine around the catheter, may require intervention but is not as urgent as the swelling and discoloration described in choice A. Choice D, moist and excoriated perineal skin folds, also needs attention but is not as concerning as the potential complications indicated by the findings in choice A.

2. A nurse is caring for a 60-year-old man who is scheduled to have coronary bypass surgery in the morning. He tells the nurse that he is afraid that he will die and he is scared of the surgery. What is the best reply for this nurse to give him?

• A. There is no reason to be scared. My father had this surgery, and now he’s playing tennis with his friends almost every day.
• B. I would be scared too. It’s a natural thing to feel. Don’t worry. Everything will be alright.
• C. You’re scared?
• D. The doctor has performed hundreds of successful bypass surgeries. I have a lot of faith in him.

Correct answer: C

Rationale: The best reply for the nurse to give the patient is option C: 'You’re scared?' This response reflects empathy and understanding, acknowledging the patient's feelings of fear. By directly addressing the patient's emotions, the nurse encourages further expression of concerns, which is crucial in providing emotional support. Choices A and D may come off as dismissive of the patient's feelings by downplaying his fear or shifting the focus to others' experiences. Choice B, although acknowledging the patient's fear, does not actively engage with the patient's emotions or encourage further discussion.

3. After a laparoscopic cholecystectomy, what is the most important instruction the nurse should give the client regarding post-operative care at home?

• A. Avoid lifting heavy objects for at least a week.
• B. Follow a low-fat diet.
• C. Monitor the incision sites for signs of infection.
• D. Resume normal activities as tolerated.

Correct answer: C

Rationale: Monitoring the incision sites for signs of infection is crucial after a laparoscopic cholecystectomy. Infections can lead to serious complications if not detected early. While avoiding heavy lifting and following a low-fat diet are important aspects of recovery, monitoring for infection takes precedence as it directly impacts the client's immediate post-operative well-being. Therefore, option C is the correct answer as it addresses the most critical aspect of post-operative care.

4. Which condition is commonly screened for in newborns using the Guthrie test?

• A. Phenylketonuria (PKU)
• B. Cystic fibrosis
• C. Down syndrome
• D. Sickle cell anemia

Correct answer: A

Rationale: The Guthrie test is specifically designed to screen newborns for phenylketonuria (PKU), a metabolic disorder that can lead to intellectual disability if left untreated. Phenylketonuria is caused by the deficiency of an enzyme required to metabolize the amino acid phenylalanine. Screening for PKU in newborns is crucial as early diagnosis and intervention can prevent the severe consequences associated with the condition. Choices B, C, and D are incorrect as the Guthrie test is not used to screen for cystic fibrosis, Down syndrome, or sickle cell anemia.

5. The nurse is performing a psychosocial assessment on an adolescent aged 14. Which emotional response is typical during early adolescence?

• A. Frequent anger
• B. Cooperativeness
• C. Moodiness
• D. Combativeness

Correct answer: C

Rationale: Moodiness is a typical emotional response during early adolescence. Hormonal changes and developmental challenges contribute to this behavior. While anger and combativeness can also be present during adolescence, they are not as consistently typical as moodiness. Cooperativeness, on the other hand, is a trait more commonly associated with later stages of development and maturity, rather than early adolescence.

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