Nursing Elites

1. Which of the following birthmarks usually fade or regress as the child gets older?

• A. Hemangiomas
• B. Congenital dermal melanocytosis (i.e., Mongolian spots)
• C. Macular stains
• D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains

Correct answer: D

Rationale: The correct answer is Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains. These three types of birthmarks are known to fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and disappear over time. Congenital dermal melanocytosis, commonly known as Mongolian spots, usually fade by adolescence. Macular stains, also called salmon patches, tend to lighten and fade as a child grows. The other choices are incorrect because they do not typically fade or regress with age.

2. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.

3. A college student has a TB test prior to starting the semester. The tuberculin test site is noted with a reddened, raised area. What condition will the student be diagnosed with if the chest radiograph is negative?

• A. Transmission
• B. Primary infection
• C. Latent tuberculosis
• D. Active tuberculosis

Correct answer: C

Rationale: If the chest radiograph is negative despite a positive tuberculin skin test, the student will be diagnosed with latent tuberculosis infection. Latent tuberculosis means the student has the TB bacteria in their body but does not feel sick and cannot spread the disease. Choice A, 'Transmission,' is incorrect as it refers to the spread of TB from person to person. Choice B, 'Primary infection,' is incorrect because primary infection occurs when a person is first infected with the TB bacteria. Choice D, 'Active tuberculosis,' is incorrect as this refers to the active form of the disease where the person feels sick and can spread TB to others.

4. A home care nurse visits a patient who is bed-bound and lives in a 12-story high-rise apartment complex. Her daughter states that she has small red skin lesions over her body and she has been itching. What parasite is most likely responsible for this patient's skin lesions?

• A. Sarcoptes scabiei
• B. Pediculus humanus corporis
• C. Pediculus humanus pubis
• D. Toxoplasma gondii

Correct answer: A

Rationale: The correct answer is Sarcoptes scabiei. Sarcoptes scabiei is a parasitic mite that causes scabies, characterized by small red skin lesions and intense itching. Pediculosis corporis (choice B) refers to body lice, which do not cause the specific symptoms described. Pediculosis pubis (choice C) is caused by pubic lice and presents differently from the symptoms described. Toxoplasma gondii (choice D) is a parasite that causes toxoplasmosis, but it does not typically manifest with small red skin lesions and itching.

5. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

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