Nursing Elites

1. What should an adolescent with type 1 diabetes do if an insulin reaction is experienced while at a basketball game?

• A. Call your parents immediately.
• B. Buy a soda and hamburger to eat.
• C. Administer insulin as soon as possible.
• D. Leave the arena and rest until the symptoms subside.

Correct answer: B

Rationale: Choosing option B, 'Buy a soda and hamburger to eat,' is the most appropriate action for an adolescent with type 1 diabetes experiencing an insulin reaction during a basketball game. In this situation, the individual is likely experiencing hypoglycemia, and consuming a soda provides a quick source of sugar to raise blood glucose levels rapidly. The hamburger can offer a more sustained release of energy due to its protein and fat content. Option A is incorrect because while contacting parents for help may be necessary in some situations, immediate action to address hypoglycemia is crucial. Option C is incorrect because administering insulin would further lower blood sugar levels, worsening the condition. Option D is incorrect as leaving the arena without addressing the hypoglycemia can lead to a worsening of symptoms and potentially dangerous outcomes.

2. When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to

• A. ask the patient to sign a release form
• B. ask a female EMT-B to attempt to assess the patient
• C. explain to the patient that she must be examined
• D. transport the patient without performing an assessment

Correct answer: B

Rationale: In this scenario, the patient has requested not to be touched, indicating a need for sensitivity and understanding. Asking a female EMT-B to attempt to assess the patient is the most appropriate initial action as it respects the patient's need for privacy, comfort, and potentially reduces re-traumatization. Asking the patient to sign a release form (Choice A) is not suitable as it disregards the patient's immediate concerns. Explaining to the patient that she must be examined (Choice C) may further distress her and violate her autonomy. Transporting the patient without performing an assessment (Choice D) ignores the patient's expressed wishes and may lead to inadequate care.

3. Which nursing intervention provides the most support to the parents of an infant with an obvious physical anomaly?

• A. Encourage them to express their concerns.
• B. Discourage them from talking about their baby.
• C. Assure them not to worry because the anomaly can be repaired.
• D. Show them postoperative photographs of infants who had a similar anomaly.

Correct answer: A

Rationale: Encouraging parents to express their concerns is the most supportive intervention as it allows them to process their emotions and provides an opportunity for the nurse to offer appropriate support and information. This choice focuses on validating the parents' feelings and creating an open communication channel. Choices B and C are incorrect as they can hinder the parents' emotional processing and may provide false reassurance. Choice D, showing postoperative photographs, may not be appropriate at this stage as it might not address the parents' current emotional needs and could induce anxiety or unrealistic expectations.

4. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect when palpating the infant’s abdomen?

• A. A distended colon
• B. Marked tenderness around the umbilicus
• C. An olive-sized mass in the right upper quadrant
• D. Rhythmic peristaltic waves in the lower abdomen

Correct answer: C

Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS due to the hypertrophied pylorus muscle. Choices A, B, and D are incorrect. A distended colon is not typically associated with HPS. Marked tenderness around the umbilicus is not a specific finding of HPS. Rhythmic peristaltic waves in the lower abdomen are not expected in HPS, as the condition primarily affects the pylorus region of the stomach.

5. Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

• A. pulmonary infection
• B. right-to-left shunt of blood
• C. decreased workload on left side of the heart
• D. increased pulmonary vascular congestion

Correct answer: D

Rationale: The correct answer is D: increased pulmonary vascular congestion. Surgical repair of patent ductus arteriosus (PDA) aims to prevent the complications associated with increased pulmonary vascular congestion, such as pulmonary hypertension and heart failure. Choice A, pulmonary infection, is not a direct complication of PDA but can occur secondary to other conditions. Choice B, right-to-left shunt of blood, is a feature of some congenital heart defects but not a direct complication of PDA. Choice C, decreased workload on the left side of the heart, is not a primary reason for surgical repair of PDA, as the main concern is the impact on pulmonary circulation.

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