Nursing Elites

1. Which observation of the exposed abdomen is most indicative of pyloric stenosis?

• A. abdominal rigidity
• B. substernal retraction
• C. palpable olive-like mass
• D. marked distention of the lower abdomen

Correct answer: C

Rationale: In pyloric stenosis, a palpable olive-like mass in the abdomen is a classic finding. This mass is due to the hypertrophied pyloric muscle. Abdominal rigidity (choice A) is associated with conditions like peritonitis, substernal retraction (choice B) is typically seen in respiratory distress, and marked distention of the lower abdomen (choice D) is more characteristic of conditions like intestinal obstruction rather than pyloric stenosis.

2. A group of nursing students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The correct answer is 'Hormonal secretion' (Choice B). The primary function of the endocrine system is to secrete hormones that regulate various bodily functions such as metabolism, growth, and reproduction. Choice A, 'Regulation of water balance,' is primarily controlled by the kidneys and the urinary system, not the endocrine system. Choice C, 'Cellular metabolism,' is more directly related to the functions of individual cells rather than the overall function of the endocrine system. Choice D, 'Growth stimulation,' is a function that can be influenced by hormones secreted by the endocrine system, but it is not the primary function of the system.

3. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

• A. Skeletal traction
• B. Physical therapy
• C. Orthotics
• D. Occupational therapy

Correct answer: A

Rationale: In caring for a child with cerebral palsy, skeletal traction is least likely to be a part of the treatment plan. Cerebral palsy is a neurological disorder affecting movement and muscle coordination, and skeletal traction, which involves applying a pulling force on a bone to correct alignment, is not a common intervention for this condition. Physical therapy, orthotics, and occupational therapy are more commonly used in the management of cerebral palsy. Physical therapy helps improve mobility and strength, orthotics assist in supporting and aligning the body, and occupational therapy focuses on enhancing daily living skills and independence. Therefore, skeletal traction is the least likely treatment option among the choices provided.

4. A group of students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The primary function of the endocrine system is hormonal secretion. This system is responsible for producing and releasing hormones that regulate various bodily functions such as growth, metabolism, and mood. Choice A, regulation of water balance, is more related to the functions of the renal system rather than the endocrine system. Choice C, cellular metabolism, is a general cellular process that involves various systems, not specific to the endocrine system. Choice D, growth stimulation, though hormones can influence growth, it is not the primary function of the endocrine system. Therefore, the correct answer is B.

5. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

• A. They will increase tidal volumes.
• B. Drainage of air and fluid will be facilitated.
• C. They will maintain positive intrapleural pressure.
• D. Pressure on the pericardium and chest wall will be regulated.

Correct answer: B

Rationale: Chest tubes are necessary after open-heart surgery to facilitate the drainage of air and fluid from the chest cavity. These tubes help prevent complications such as pneumothorax (accumulation of air in the pleural space) or cardiac tamponade (build-up of fluid in the pericardial sac), which can be serious postoperative issues. Options A, C, and D are incorrect because chest tubes are primarily used for draining purposes and not for increasing tidal volumes, maintaining positive intrapleural pressure, or regulating pressure on the pericardium and chest wall.

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