Nursing Elites

1. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

• A. Vesicular
• B. Bronchial
• C. Adventitious
• D. Bronchovesicular

Correct answer: A

Rationale: Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.

2. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?

• A. S1 and S2
• B. S3 and S4
• C. Murmur
• D. Physiologic splitting

Correct answer: C

Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.

3. What is the most critical physiological change required of newborns at birth?

• A. Transition from fetal to neonatal breathing
• B. Body temperature maintenance
• C. Stabilization of fluid and electrolytes
• D. Closure of fetal shunts in the heart

Correct answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The most critical physiological change required of newborns at birth is the initiation of breathing. This transition is crucial for the newborn to start exchanging oxygen and carbon dioxide outside the womb, marking the beginning of their independent respiratory function. Choices B, C, and D are important aspects of newborn care but are not as immediately critical as the establishment of breathing for oxygenation and removal of carbon dioxide, which is essential for the newborn's survival and adaptation to extrauterine life.

4. A 14-year-old with chronic renal failure suddenly becomes non-compliant with the medication regimen. Which nursing intervention would most likely improve compliance?

• A. Give the child a computer-animated game that presents information on the management of chronic renal failure.
• B. Set up a meeting with some older teens who have chronic renal failure and have been managing their disease effectively.
• C. Arrange for a physician to sit down and talk to the child about the risks related to noncompliance with medications.
• D. Discuss with the child’s parents that privileges, such as a cell phone, can be taken away if compliance fails to improve.

Correct answer: B

Rationale: Adolescents often seek guidance and support from their peers. Setting up a meeting with older teens who are effectively managing chronic renal failure can provide the 14-year-old with motivation, encouragement, and practical advice on how to handle their treatment regimen. This peer support can positively influence the non-compliant adolescent, making choice B the most likely intervention to improve compliance. Choices A and C may not address the peer influence aspect of adolescent behavior, while choice D focuses on punitive measures rather than addressing the underlying reasons for non-compliance.

5. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?

• A. Ask her why she wants to know.
• B. Determine why she is so anxious.
• C. Explain in simple terms how it works.
• D. Tell her she will see how it works as it is used.

Correct answer: C

Rationale: Providing a simple explanation satisfies the child's curiosity and helps reduce any anxiety about the procedure.

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