Nursing Elites

1. A nurse assisting with data collection is preparing to assess the optic nerve. The nurse performs this examination by using which technique?

• A. Assessing visual acuity
• B. Inspecting the eyelids for ptosis
• C. Assessing pupil constriction
• D. Assessing ocular movements

Correct answer: A

Rationale: The correct technique to assess the optic nerve is by testing visual acuity and visual fields through confrontation. Visual acuity involves assessing the clarity of vision, which directly correlates with the function of the optic nerve. Inspecting the eyelids for ptosis is unrelated to optic nerve assessment. Assessing pupil constriction is more related to the assessment of cranial nerves controlling eye movements, particularly the oculomotor nerve. Assessing ocular movements is related to testing the abducens, oculomotor, and trochlear nerves, not specifically the optic nerve.

2. All of the following are clinical manifestations indicating male climacteric except:

• A. hot flashes
• B. loss of reproductive ability
• C. headaches
• D. heart palpitations

Correct answer: B

Rationale: Male climacteric, also known as andropause, is a stage in a man's life characterized by a decline in testosterone levels and various physical and emotional changes. While men may experience symptoms like hot flashes, headaches, and heart palpitations during male climacteric, they do not typically lose their reproductive ability. Although fertility may decrease with age due to reduced testosterone production, men do not entirely lose the ability to reproduce. Therefore, the correct answer is 'loss of reproductive ability.' Choices A, C, and D are symptoms that can be associated with male climacteric, making them incorrect answers.

3. After undergoing gastric resection, which of the following meals is most likely to cause rapid emptying of the stomach?

• A. a high-protein meal
• B. a high-fat meal
• C. a large meal regardless of nutrient content
• D. a high-carbohydrate meal

Correct answer: D

Rationale: After gastric resection, meals high in carbohydrates are more likely to cause rapid emptying of the stomach. Carbohydrates stimulate the release of gastrin, which accelerates gastric emptying. In contrast, high-fat and high-protein meals tend to delay gastric emptying. While a large meal can slow down gastric emptying, the specific nutrient content, such as high carbohydrates, plays a significant role in promoting rapid emptying. Therefore, a high-carbohydrate meal is the correct choice as it is most likely to lead to rapid gastric emptying compared to the other options.

4. The parents of an adolescent tell the school nurse that they are frustrated because their daughter has become self-centered, lazy, and irresponsible. The nurse should provide which response to the parents?

• A. That this is normal behavior for an adolescent
• B. That their daughter's behavior may be a part of adolescent development
• C. That this behavior could be a phase as the adolescent explores identity
• D. To restrict any social privileges until the behavior stops

Correct answer: A

Rationale: During adolescence, identity formation is a significant developmental task. Adolescents may appear self-centered, lazy, or irresponsible as they focus on themselves and explore their identity. Erikson describes this phase as identity formation versus role confusion. It is common for frustrated parents to perceive teenagers this way. The adolescent needs time to introspect and develop a sense of self. Suggesting that the behavior requires a child psychologist is premature and not supported by normal adolescent development. Blaming the behavior on parental spoiling is also inaccurate and unhelpful. Restricting social privileges can lead to resentment and rebellion, rather than addressing the root of the behavior.

5. What is the therapeutic range for carbamazepine (Tegretol)?

• A. 7-12 mcg/mL
• B. 4-10 mcg/mL
• C. 10-14 mcg/mL
• D. 1-5 mcg/mL

Correct answer: B

Rationale: The therapeutic range for carbamazepine (Tegretol) is 4-10 mcg/mL. This range is established based on the optimal balance between effectiveness and safety. Choices A, C, and D are outside the therapeutic range for carbamazepine, which could lead to suboptimal treatment outcomes or increased risk of toxicity. Choice B (4-10 mcg/mL) is the correct range recommended for therapeutic efficacy while minimizing adverse effects.

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