Nursing Elites

1. Melena, the passage of black, tarry stools, suggests bleeding from which source?

• A. The perianal or rectal area
• B. The upper gastrointestinal (GI) tract
• C. The lower GI tract
• D. Hemorrhoids or anal fissures

Correct answer: B

Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.

2. What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?

• A. Metabolic acidosis
• B. Respiratory alkalosis
• C. Metabolic and respiratory acidosis
• D. Metabolic and respiratory alkalosis

Correct answer: D

Rationale: Both metabolic and respiratory alkalosis can cause overexcitability and nervous system stimulation due to a decrease in ionized calcium levels, which can cause symptoms such as tetany and paresthesias. Acidosis typically has the opposite effect, leading to depression of the nervous system.

3. The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect?

• A. Anemia
• B. Anorexia
• C. All are applicable
• D. Intestinal colic

Correct answer: D

Rationale: A heavy roundworm infection can cause anemia, anorexia, irritability, and an enlarged abdomen due to the worms’ effects on nutrient absorption and intestinal function.

4. What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age?

• A. Give large push-pull toys for kinetic stimulation
• B. Place a cradle gym across the crib to help develop fine motor skills
• C. Provide the child with finger paints to enhance fine motor skills
• D. Provide a stick horse to develop gross motor coordination

Correct answer: A

Rationale: Large push-pull toys are suitable for a 12-month-old as they encourage gross motor skills and physical activity, which are crucial for their development at this age.

5. Which parameter correlates best with measurements of total muscle mass?

• A. Height
• B. Weight
• C. Skinfold thickness
• D. Upper arm circumference

Correct answer: D

Rationale: Upper arm circumference correlates best with total muscle mass because it includes both muscle and fat components, making it a reliable indicator of muscle mass.

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