Nursing Elites

1. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?

• A. Inflamed throat with exudate
• B. Purulent eye drainage
• C. Dry, hacking cough
• D. Koplik spots on buccal mucosa

Correct answer: C

Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.

2. An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?

• A. Necrotizing enterocolitis (NEC)
• B. Ulcerative colitis (UC)
• C. Crohn's disease
• D. Appendicitis

Correct answer: B

Rationale: Ulcerative colitis is a type of inflammatory bowel disease characterized by recurrent abdominal pain, diarrhea, and bloody stools. The symptoms described align with the clinical presentation of ulcerative colitis, making it the most likely diagnosis in this scenario. Necrotizing enterocolitis primarily affects premature infants, Crohn's disease typically presents with non-bloody diarrhea, and appendicitis is characterized by right lower quadrant abdominal pain. Therefore, based on the symptoms provided, ulcerative colitis is the most appropriate suspicion.

3. A healthcare professional is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the professional have on hand for the delivery?

• A. Bag-valve-mask system
• B. Sterile gauze and saline
• C. Soft arm restraints
• D. Endotracheal tube

Correct answer: D

Rationale: An endotracheal tube is crucial for managing the airway of a newborn with a diaphragmatic hernia. In this condition, there may be respiratory distress due to incomplete development of the diaphragm, allowing abdominal organs to move into the chest cavity and compress the lungs. The endotracheal tube helps in securing the airway and providing respiratory support if needed until definitive treatment can be initiated.

4. During a developmental screening, a 4-year-old child is asked to perform a task. Which of the following tasks should the nurse expect the child to perform?

• A. Draw a stick figure with seven body parts
• B. Draw a circle
• C. Identify right from left hand
• D. Tie their shoelaces

Correct answer: B

Rationale: At 4 years old, children are typically able to draw a circle, which is a developmental milestone for their age. Drawing a stick figure with specific body parts might be beyond their developmental level, identifying right from left hand can be challenging, and tying shoelaces requires more advanced motor skills.

5. At what age may an infant close their eyes to bright lights and show improved head control?

• A. 30-33 weeks after conception
• B. 34-36 weeks after conception
• C. Less than 30 weeks after conception
• D. 37-40 weeks after conception

Correct answer: A

Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.

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