Nursing Elites

1. A child is diagnosed with a Greenstick Fracture. Which of the following most accurately describes the broken bone?

• A. compound fracture of the fibula
• B. a partial break in a long bone
• C. fracture of the growth plate of the ulna near the wrist
• D. Colles fracture of the tibia

Correct answer: B

Rationale: A Greenstick Fracture is commonly found in children due to their bones being more flexible. This type of fracture occurs when a bone bends and partially breaks, resembling what happens when a green stick from a tree is bent in half. Therefore, the most accurate description of a Greenstick Fracture is 'a partial break in a long bone.' Choice A, 'compound fracture of the fibula,' is incorrect as a Greenstick Fracture is not a compound fracture. Choice C, 'fracture of the growth plate of the ulna near the wrist,' is incorrect as it describes a different type of fracture. Choice D, 'Colles fracture of the tibia,' is incorrect as it refers to a specific type of fracture in a different bone.

2. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

• A. Bile-stained fecal emesis
• B. The passage of currant jelly-like stools
• C. Failure to pass meconium stool in the first 24 hours after birth
• D. Sausage-shaped mass palpated in the upper right abdominal quadrant

Correct answer: C

Rationale: Imperforate anus is the incomplete development or absence of the anus in its normal position in the perineum. Failure to pass meconium stool within the first 24 hours after birth is a key clinical manifestation associated with this disorder. This finding should prompt further assessment to confirm the suspected diagnosis. Other assessment findings in imperforate anus may include absence or stenosis of the anal rectal canal, presence of an anal membrane, and an external fistula to the perineum. Options A, B, and D describe findings typically noted in intussusception, a different condition characterized by bowel obstruction and telescoping of the intestines that can present with bile-stained fecal emesis, the passage of currant jelly-like stools, and a sausage-shaped mass palpated in the upper right abdominal quadrant.

3. Which of the following diseases is caused by the Bordetella pertussis bacterium?

• A. German Measles
• B. RSV
• C. Meningitis
• D. Whooping Cough

Correct answer: D

Rationale: Bordetella pertussis is the bacterium responsible for causing Whooping Cough, also known as pertussis. Meningitis can be caused by various bacteria, but not specifically by Bordetella pertussis. German Measles, also known as Rubella, and RSV (Respiratory Syncytial Virus) are viral infections and are not caused by the Bordetella pertussis bacterium. Therefore, the correct answer is Whooping Cough, caused by Bordetella pertussis.

4. A patient presents to the office with a pencil that has completely penetrated the palm of her hand. Which of the following treatments would be BEST in this situation?

• A. Assist the doctor while he sedates the patient and removes the pencil from her hand.
• B. Have the patient gently pull the pencil out of her hand and assist the physician with stitches.
• C. Wrap a gauze around the pencil, securing it as much as possible until the patient can get to a local emergency room.
• D. Tell the patient to go to the local emergency room. With a doctor's order, give the patient some aspirin for the pain.

Correct answer: C

Rationale: Penetrating wounds that leave an object behind may have damaged important blood vessels. Removing the object may lead to significant bleeding. The correct approach is to gently wrap the wound with the object in place to help control bleeding and prevent further injury. The patient should be taken promptly to the nearest emergency room where healthcare professionals can safely and appropriately remove the object and provide necessary treatment. Choice A is incorrect because removing the pencil without proper medical evaluation can worsen the injury. Choice B is incorrect because pulling out the object can cause additional damage and bleeding. Choice D is incorrect because giving aspirin without knowing the extent of the injury and causing potential drug interactions can be harmful.

5. When orally administering alendronate (Fosamax), a bisphosphonate drug, to a largely bed-bound patient being treated for osteoporosis, what is the most important nursing consideration?

• A. Sit the head of the bed up for 30 minutes after administration
• B. Give the patient a small amount of water to drink
• C. Feed the patient soon, at most 10 minutes after administration
• D. Assess the patient for back pain or abdominal pain

Correct answer: A

Rationale: The correct nursing consideration when administering bisphosphonates like alendronate is to sit the head of the bed up for 30 minutes after administration. Bisphosphonates are known to cause esophageal irritation, which can lead to esophagitis. By sitting upright, the patient reduces the time the medication spends in the esophagus, decreasing the risk of irritation and potential adverse effects. Giving the patient water to drink or feeding them immediately after administration can increase the risk of esophageal irritation. Assessing the patient for back pain or abdominal pain is important but not the most critical consideration during drug administration.

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