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 2-year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?

• A. Neurotoxicity
• B. Hepatomegaly
• C. Nephrotoxicity
• D. Ototoxicity

Correct answer: C

Rationale: The correct answer is nephrotoxicity. Calcium disodium edetate, used in chelation therapy for lead poisoning, can lead to kidney toxicity. This is an important side effect to monitor in patients undergoing this treatment. Choices A, B, and D are incorrect. Neurotoxicity, hepatomegaly, and ototoxicity are not typically associated with calcium disodium edetate therapy for lead poisoning.

3. A patient asks the nurse why they must have a heparin injection. What is the nurse's best response?

• A. Heparin will dissolve clots that you have.
• B. Heparin will reduce the platelets that make your blood clot.
• C. Heparin will work better than warfarin.
• D. Heparin will prevent new clots from developing.

Correct answer: D

Rationale: The correct answer is D: 'Heparin will prevent new clots from developing.' Heparin is an anticoagulant medication that helps prevent the formation of new blood clots. It does not dissolve existing clots (choice A), reduce platelets (choice B), or necessarily work 'better' than warfarin (choice C) but rather functions differently. The primary action of heparin is to prevent the development of new clots, especially in conditions where clot formation is a concern.

4. A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acid?'

• A. Green vegetables and liver
• B. Yellow vegetables and red meat
• C. Carrots
• D. Milk

Correct answer: A

Rationale: Green vegetables and liver are rich sources of folic acid. Green vegetables like spinach, asparagus, and broccoli are high in folic acid content. Liver, especially from chicken or beef, is also a good source of folic acid. Yellow vegetables and red meat (choice B) do not contain as high a concentration of folic acid as green vegetables and liver. Carrots (choice C) are nutritious but do not have the highest concentration of folic acid. Milk (choice D) is not a significant source of folic acid compared to green vegetables and liver.

5. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record?

• A. Incessant crying
• B. Coughing at nighttime
• C. Choking with feedings
• D. Severe projectile vomiting

Correct answer: C

Rationale: In esophageal atresia and tracheoesophageal fistula, the esophagus ends before it reaches the stomach, forming a blind pouch, and there is an abnormal connection (fistula) with the trachea. Any child who exhibits the '3 Cs'"?coughing and choking with feedings and unexplained cyanosis"?should be suspected to have tracheoesophageal fistula. Option A, 'Incessant crying,' is not a typical sign of esophageal atresia with tracheoesophageal fistula. Option B, 'Coughing at nighttime,' is not a specific sign associated with this condition. Option D, 'Severe projectile vomiting,' is not a common sign of esophageal atresia with tracheoesophageal fistula.

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