Nursing Elites

1. A 6-month-old infant has been brought to the well-child clinic for a checkup. The infant is currently sleeping. What would the nurse do first when beginning the examination?

• A. Wake the infant before beginning the examination.
• B. Examine the infant's hips before the infant wakes up.
• C. Auscultate the lungs and heart while the infant is still sleeping.
• D. Begin with the assessment of the eye and continue with the remainder of the examination in a head-to-toe approach.

Correct answer: C

Rationale: When the infant is quiet or sleeping, it is an ideal time to assess the cardiac, respiratory, and abdominal systems. It is recommended not to wake the infant unnecessarily. Auscultating the lungs and heart while the infant is still sleeping allows for a comprehensive assessment without disturbing the infant. Examining the infant's hips prematurely may disrupt the infant's sleep. Starting with an assessment of the eye is not appropriate as it is an invasive procedure and should be performed towards the end of the examination after the non-invasive assessments have been completed.

2. When evaluating the temperature of older adults, what aspect should the healthcare provider remember about an older adult's body temperature?

• A. The body temperature of the older adult is lower than that of a younger adult.
• B. An older adult's body temperature is approximately the same as that of a young child.
• C. Body temperature varies based on the type of thermometer used.
• D. In older adults, body temperature can fluctuate widely due to less effective heat control mechanisms.

Correct answer: A

Rationale: When evaluating the temperature of older adults, it is important to note that their body temperature is usually lower than that of younger adults, with a mean temperature of 36.2�C. Choice B is incorrect because an older adult's body temperature is not approximately the same as that of a young child. Choice C is incorrect because body temperature is a physiological parameter and does not vary based on the type of thermometer used. Choice D is incorrect because while older adults may have less effective heat control mechanisms, their body temperature is typically lower, not widely fluctuating.

3. Who is most likely to arrange the discharge of a patient to their own home, a nursing home, or an assisted living facility?

• A. A physical therapist
• B. A speech therapist
• C. A social worker
• D. An occupational therapist

Correct answer: C

Rationale: Social workers play a crucial role in arranging patient discharges to suitable facilities. They collaborate with healthcare professionals to ensure that patients are transitioned to the most appropriate setting post-hospitalization. Social workers focus on the holistic needs of patients, including their social and emotional well-being, to facilitate a smooth continuum of care. Choices A, B, and D do not typically have the primary responsibility for arranging patient discharges to various facilities.

4. The nurse is assessing the vital signs of a 20-year-old marathon runner and documents the following vital signs: temperature"?36�C; pulse"?48 beats per minute; respirations"?14 breaths per minute; blood pressure"?104/68 mm Hg. Which statement is true concerning these results?

• A. The patient is experiencing bradycardia.
• B. These are normal vital signs for a healthy, athletic adult.
• C. The patient's pulse rate is not normal"?no action is required.
• D. The patient's next clinic visit should occur as scheduled.

Correct answer: B

Rationale: The correct answer is, 'These are normal vital signs for a healthy, athletic adult.' A pulse rate of 48 beats per minute is considered bradycardia in adults, but it is not a concern in well-trained athletes like marathon runners. Bradycardia is a normal physiological response to aerobic conditioning. Tachycardia, on the other hand, is defined as a pulse rate above 100 beats per minute, which is not the case here. The low pulse rate in this scenario is a reflection of the athlete's cardiovascular fitness. Therefore, there is no need to notify the physician or schedule a follow-up visit based on these findings.

5. Which of the following organs would be described as being located retroperitoneally?

• A. Kidneys
• B. Thymus
• C. Small Intestines
• D. Spleen

Correct answer: A

Rationale: The term 'retroperitoneal' refers to organs positioned behind the peritoneum. The kidneys are retroperitoneal organs, located outside the peritoneal cavity, against the posterior abdominal wall. This positioning provides them with additional protection from external forces due to the surrounding structures. The thymus, small intestines, and spleen are not retroperitoneal organs. The thymus is located in the mediastinum, the small intestines are intraperitoneal, and the spleen is intraperitoneal and located in the left upper quadrant of the abdomen.

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