Nursing Elites

1. Which gland of the endocrine system secretes a hormone that assists with the sleep/wake cycle?

• A. Pituitary
• B. Pineal
• C. Pancreas
• D. Hypothalamus

Correct answer: B

Rationale: The correct answer is the Pineal gland. The Pineal gland, located in the brain, secretes melatonin, which plays a crucial role in regulating the sleep/wake cycle in response to exposure to light. The Pituitary gland (Choice A) secretes various hormones but not specifically related to the sleep/wake cycle. The Pancreas (Choice C) secretes insulin and digestive enzymes, not hormones related to the sleep/wake cycle. The Hypothalamus (Choice D) is involved in regulating many bodily functions, including hormone secretion, but it does not directly secrete the hormone that regulates the sleep/wake cycle.

2. During an examination, a nurse notices a draining ulceration on a patient's lower leg. What is the most appropriate action in this situation?

• A. Wash hands and then contact the physician.
• B. Continue to examine the ulceration and then wash hands.
• C. Wash hands, put on gloves, and continue with the examination of the ulceration.
• D. Wash hands, proceed with the rest of the physical examination, and perform the examination of the leg ulceration last.

Correct answer: C

Rationale: In this scenario, the most appropriate action is to wash hands, put on gloves, and then continue examining the ulceration. Wearing gloves is crucial when there is a possibility of contact with body fluids, as in the case of a draining ulceration. Contacting the physician is not necessary at this point; the immediate focus should be on proper infection control by washing hands and wearing gloves. Changing the order of the examination is not recommended as it is important to follow a systematic approach to avoid missing any crucial assessments.

3. A patient has suddenly developed shortness of breath and appears to be in significant respiratory distress. After calling the physician and placing the patient on oxygen, which of these actions is the best for the nurse to take when further assessing the patient?

• A. Count the patient's respirations.
• B. Bilaterally percuss the thorax, noting any differences in percussion tones.
• C. Call for a chest x-ray and wait for the results before beginning an assessment.
• D. Inspect the thorax for any new masses and bleeding associated with respirations.

Correct answer: B

Rationale: In a situation where a patient is in significant respiratory distress, bilaterally percussing the thorax to note any differences in percussion tones is a crucial nursing intervention. Percussion provides instant feedback regarding changes in underlying tissue density, which can give important clues about the patient's physical status. This hands-on assessment technique is readily available and can be performed promptly. Counting the patient's respirations, while important, may not provide as much detailed information as percussion. Ordering a chest x-ray and waiting for the results can cause a delay in assessing and addressing the patient's immediate needs. Inspecting the thorax for new masses and bleeding, although relevant, may not offer as much real-time information about the patient's condition compared to percussion.

4. Which of the following questions is considered open-ended?

• A. What time did you last take your medications?
• B. Are you feeling okay right now?
• C. Please describe your symptoms.
• D. What day are you available for a follow-up appointment?

Correct answer: C

Rationale: The correct answer is 'Please describe your symptoms.' This question is considered open-ended because it encourages the respondent to provide a detailed and descriptive answer, fostering a more elaborate response. Open-ended questions are designed to prompt thoughtful and detailed responses. Choice A is a closed-ended question since it seeks a specific time for the medication intake. Choice B is also closed-ended as it can be answered with a simple 'yes' or 'no,' limiting the response. Choice D is closed-ended as it requests a specific day for the follow-up appointment, restricting the range of possible responses.

5. Which of the following is NOT an acceptable abbreviation?

• A. D/C
• B. tid
• C. bid
• D. qid

Correct answer: A

Rationale: The correct answer is A: D/C. D/C is not an acceptable abbreviation as it can be easily confused with both 'discharge' and 'discontinue.' The abbreviations 'tid' (three times a day), 'bid' (twice a day), and 'qid' (four times a day) are commonly used in medical contexts to indicate dosing frequencies and are widely accepted in healthcare settings.

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