Nursing Elites

1. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

2. What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

• A. Infarction of renal vessels
• B. Immune complex formation and glomerular deposition
• C. Bacterial endotoxin deposition on and destruction of glomeruli
• D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation

Correct answer: B

Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.

3. The nurse is caring for a 1-month-old infant diagnosed with Hirschsprung’s disease. Which treatment measure should be included in the plan of care?

• A. Barium Enema
• B. Surgical removal of the affected section of bowel
• C. High-fiber diet
• D. Permanent colostomy

Correct answer: B

Rationale: The correct answer is B: Surgical removal of the affected section of bowel. Hirschsprung's disease is a congenital condition where a portion of the large intestine lacks nerve cells, leading to difficulties in passing stool. The definitive treatment for this condition is the surgical removal of the affected section of the bowel. Barium enema (Choice A) may be used for diagnosis but is not a treatment. A high-fiber diet (Choice C) is not effective in managing Hirschsprung's disease. A permanent colostomy (Choice D) is not the initial treatment for this condition in infants.

4. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

• A. Vesicular
• B. Bronchial
• C. Adventitious
• D. Bronchovesicular

Correct answer: A

Rationale: Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.

5. When transitioning from intravenous to oral morphine, what would the nurse anticipate regarding the oral dose in comparison to the intravenous dose to achieve equianalgesia?

• A. Same as the intravenous dose
• B. Greater than the intravenous dose
• C. One half of the intravenous dose
• D. One fourth of the intravenous dose

Correct answer: B

Rationale: When switching from intravenous to oral morphine, a higher oral dose is required to achieve equianalgesia due to significant metabolism from the first-pass effect. Choosing the same oral dose as the intravenous dose would provide less pain relief. Opting for a dose greater than the intravenous dose is necessary to achieve the same analgesic effect. Therefore, options A, C, and D are incorrect.

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