Nursing Elites

1. Which anatomic malformations are associated with Tetralogy of Fallot?

• A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
• B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow
• C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
• D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow

Correct answer: D

Rationale: Tetralogy of Fallot is characterized by a combination of four heart defects: a sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow obstruction. This leads to mixing of oxygen-poor and oxygen-rich blood, resulting in cyanosis. Therefore, the correct answer is D. Choices A, B, and C are incorrect because they do not accurately describe the specific combination of anatomic malformations seen in Tetralogy of Fallot.

2. While caring for a four-year-old female patient who was severely burned in a house fire, how would you determine the extent of this child's burns?

• A. By using the Lund and Browder chart
• B. By using the Rule of Nines
• C. By using the Rule of Tens
• D. By using the Parkland Formula

Correct answer: A

Rationale: The correct answer is A: By using the Lund and Browder chart. The Lund and Browder chart is specifically designed to assess the extent of burns in children accurately, taking into account the variation in body proportions as children grow. This method provides a more precise estimation of the total body surface area affected by burns in pediatric patients. Choices B, C, and D are incorrect. The Rule of Nines is more suitable for adults, not children. The Rule of Tens is not a standard method for assessing burn extent, and the Parkland Formula is used to calculate fluid resuscitation requirements in burn patients, not to determine the extent of burns.

3. A nurse at a long-term care facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

• A. Apply vest restraints to residents who are confused
• B. Keep all four side rails up on beds at night
• C. Accompany residents over 85 years of age during ambulation
• D. Implement rounds every 2 hours during the day to offer toileting

Correct answer: D

Rationale: The correct answer is to implement rounds every 2 hours during the day to offer toileting. This intervention helps prevent falls by addressing the common cause of unassisted mobility, which is the need to use the bathroom. Choice A is incorrect as restraints should not be the first choice for fall prevention due to the risk of injury and loss of independence. Choice B is incorrect because all side rails up can lead to entrapment and should only be used based on individualized assessments. Choice C may not be feasible for all residents over 85 years old and does not directly address the risk of falls.

4. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.

• A. It stimulates the pancreas to produce more insulin.
• B. It must be taken after meals.
• C. It decreases sugar production in the liver.
• D. It inhibits absorption of carbohydrates.

Correct answer: A

Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.

5. A nurse is caring for a client who requests information about the prevalence of Tay-Sachs disease. Which of the following resources should the nurse use to obtain this information?

• A. The client's health care provider
• B. A collaborative, user-edited website
• C. The facility's case manager
• D. An evidence-based nursing journal

Correct answer: D

Rationale: An evidence-based nursing journal is the correct choice for the nurse to obtain information about the prevalence of Tay-Sachs disease. These journals contain peer-reviewed research and studies conducted by experts in the field, providing accurate and reliable information. Choice A, the client's health care provider, may have general information but may not provide detailed prevalence data. Choice B, a collaborative, user-edited website, is not a reliable source as the information may be inaccurate or outdated. Choice C, the facility's case manager, is unlikely to have specific prevalence data on Tay-Sachs disease.

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