Nursing Elites

1. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?

• A. Creation of national health insurance exchanges for affordable insurance coverage
• B. Expansion of school-based health centers
• C. Free preventative services for all
• D. Medically managed clinics eligible for federal funding

Correct answer: B

Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.

2. You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:

• A. 8 to 12 months of age.
• B. 20 to 24 months of age.
• C. 16 to 20 months of age.
• D. 12 to 16 months of age.

Correct answer: A

Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.

3. A nurse in a long-term care facility is caring for a client who reports the AP repositioned him in bed using excessive force. Which of the following actions should the nurse take?

• A. Document in the client's chart that an incident report has been filed.
• B. Contact the nurse manager.
• C. Reassure the client that the staff is well trained.
• D. Call risk management to interview the client.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to contact the nurse manager. By doing so, the nurse can escalate the issue appropriately, ensuring that the incident is addressed and necessary actions are taken. Documenting in the client's chart that an incident report has been filed (Choice A) may be necessary but should not be the first step. Reassuring the client that the staff is well trained (Choice C) does not address the client's concern and the need for intervention. Calling risk management to interview the client (Choice D) may be premature at this stage and should be handled by the nurse manager first.

4. What are the fine, down-like hairs on the newborn's ears, shoulders, lower back, and/or forehead known as?

• A. Vernix.
• B. Lanugo.
• C. Milia.
• D. Vibrissae.

Correct answer: B

Rationale: Lanugo is the term used to describe the fine, down-like hairs found on a newborn's ears, shoulders, lower back, and/or forehead. These hairs are different from vernix, which is a waxy or cheese-like white substance covering the skin of newborns. Milia are small, white, or yellowish cysts that commonly appear on a newborn's face, while vibrissae are the thick, stiff hairs commonly found around the nose and other parts of the face.

5. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

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