Nursing Elites

1. What is the pattern of fever in enteric fever?

• A. Intermittent fever
• B. Relapsing fever
• C. Pel-Ebstein fever
• D. Continuous fever

Correct answer: D

Rationale: Enteric fever, caused by Salmonella typhi or paratyphi, is characterized by a continuous fever pattern. The fever typically persists without significant fluctuations, distinguishing it from diseases with intermittent or relapsing fever patterns. Pel-Ebstein fever, a cyclic pattern of fever seen in Hodgkin's lymphoma, is not associated with enteric fever. Relapsing fever is a characteristic of diseases like Borrelia recurrentis infection. Intermittent fever is seen in conditions like malaria.

2. When drawing blood from the diabetic patient for a glycosylated hemoglobin (HBA1c) test, the nurse explains to the woman that the test is used to determine:

• A. The highest glucose level in the past week.
• B. Her insulin levels.
• C. Glucose levels over the past three months.
• D. Her usual fasting glucose level.

Correct answer: C

Rationale: The glycosylated hemoglobin (HBA1c) test reflects the average blood sugar levels over the past three months. It provides a more comprehensive view of the individual's glucose control compared to a single point-in-time measurement like a fasting glucose level or the highest glucose level in the past week. Choice A is incorrect because it focuses on a single high glucose level rather than the overall control over a period. Choice B is incorrect as HBA1c is not a test for insulin levels. Choice D is incorrect as the HBA1c test does not reflect a single fasting glucose level but rather an average over a more extended period.

3. An infant with congestive heart failure is receiving diuretic therapy. A nurse is closely monitoring the intake and output. The nurse uses which most appropriate method to assess the urine output?

• A. Weighing the diapers
• B. Inserting a Foley catheter
• C. Comparing intake with output
• D. Measuring the amount of water added to formula

Correct answer: A

Rationale: Weighing the diapers is the most appropriate method to assess urine output in infants. Diapers will absorb and retain urine, providing a measurable indicator of urine output without invasive procedures. This method is non-invasive, simple, and convenient for monitoring urine output, especially in infants who may not be able to use other urine output measurement techniques. Inserting a Foley catheter is invasive and not indicated for routine urine output monitoring in infants. Comparing intake with output does not directly measure urine output. Measuring the amount of water added to formula does not provide an accurate assessment of urine output.

4. As a nurse caring for Asana, a 9-year-old girl with the stature of a 4-year-old due to growth hormone deficiency, which of the following will be your priority during follow-up visits?

• A. Vital signs monitoring
• B. Height and weight monitoring
• C. Bone age studies
• D. Dietary assessment

Correct answer: B

Rationale: Height and weight monitoring are essential for evaluating the growth progress in a child with growth hormone deficiency. Regular monitoring helps assess the effectiveness of treatment and ensures appropriate growth trajectory for the child.

5. When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, which of the following questions would be MOST appropriate to ask?

• A. When did you first notice the symptoms?
• B. Do you have a history of high blood pressure?
• C. What medications do you take and why?
• D. Have you previously had a heart attack?

Correct answer: A

Rationale: The most appropriate question to ask when assessing a geriatric patient who may have experienced an acute ischemic stroke is when the symptoms were first noticed. This information is crucial for determining the time window for potential treatments like thrombolytic therapy, as prompt intervention is necessary for stroke management. Option B is not as relevant in the acute assessment of stroke, though important for overall health history. Option C is important but may not be as time-sensitive as determining symptom onset. Option D focuses on a different cardiac event, not directly related to the current concern of a possible stroke.

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