Nursing Elites

1. Which of the following joints normally allows 360-degree circumflexion?

• A. The knee
• B. The shoulder
• C. The elbow
• D. The fingertips

Correct answer: B

Rationale: The correct answer is B: The shoulder. The shoulder joint is a ball-and-socket joint that allows for a wide range of motion, including 360-degree circumflexion. This joint provides flexibility and mobility in various directions. Choice A, the knee joint, primarily allows flexion and extension but does not have a 360-degree circumflexion. Choice C, the elbow joint, is a hinge joint that permits flexion and extension but not circumflexion. Choice D, the fingertips, do not form a specific joint that allows circumflexion; rather, they have joints that enable bending and straightening movements.

2. Which skin disorder most closely resembles and mimics dandruff?

• A. Lice infestation
• B. Scabies
• C. Dermatitis
• D. Acne vulgaris

Correct answer: C

Rationale: Dermatitis can closely resemble and mimic dandruff due to similar symptoms like flaking and itching. Lice infestation (choice A) is characterized by the presence of lice and their eggs attached to the hair shaft, different from dandruff. Scabies (choice B) is a contagious skin condition caused by mites, presenting as burrows, rashes, and intense itching, not typically resembling dandruff. Acne vulgaris (choice D) is a skin condition involving hair follicles and sebaceous glands, manifesting as pimples and inflammation, which is distinct from dandruff.

3. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (select one that does not apply)

• A. Reduce IV access
• B. Limit length of visits
• C. Restrict fluids to 1500 mL per day
• D. Conduct frequent neurologic checks

Correct answer: D

Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.

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 preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate?

• A. If you have the procedure now, you won't have to deal with pain and disability later.
• B. You'll be fine. You'll receive a prescription for pain medication.
• C. Why didn't you discuss your concerns with your provider?
• D. I understand and it's not too late to change your mind.

Correct answer: D

Rationale: The appropriate response acknowledges the client's concern and confirms that they have the right to change their mind.

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