Nursing Elites

1. Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

• A. pulmonary infection
• B. right-to-left shunt of blood
• C. decreased workload on left side of the heart
• D. increased pulmonary vascular congestion

Correct answer: D

Rationale: The correct answer is D: increased pulmonary vascular congestion. Surgical repair of patent ductus arteriosus (PDA) aims to prevent the complications associated with increased pulmonary vascular congestion, such as pulmonary hypertension and heart failure. Choice A, pulmonary infection, is not a direct complication of PDA but can occur secondary to other conditions. Choice B, right-to-left shunt of blood, is a feature of some congenital heart defects but not a direct complication of PDA. Choice C, decreased workload on the left side of the heart, is not a primary reason for surgical repair of PDA, as the main concern is the impact on pulmonary circulation.

2. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?

• A. Insulin
• B. Steroids
• C. Antibiotics
• D. Anticonvulsants

Correct answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A), antibiotics (Choice C), and anticonvulsants (Choice D) do not interact with the varicella vaccine in the same way as steroids, and therefore, they are not contraindicated.

3. The healthcare provider is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

• A. abdominal rigidity and pain on palpation
• B. rounded abdomen and hypoactive bowel sounds
• C. visible peristalsis and weight loss
• D. distention of lower abdomen and constipation

Correct answer: C

Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. Visible peristalsis refers to the wave-like movements in the abdomen caused by the stomach trying to empty into the intestines due to the obstruction at the pylorus. Weight loss is often seen due to inadequate feeding and vomiting associated with this condition. Choices A, B, and D are not typical of pyloric stenosis. Abdominal rigidity and pain on palpation are more indicative of conditions like peritonitis. A rounded abdomen and hypoactive bowel sounds are more suggestive of conditions like constipation or bowel obstruction. Distention of the lower abdomen and constipation are not specific to pyloric stenosis and may be seen in various gastrointestinal issues.

4. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. Absence of a urethral opening is noted
• B. Penis appears shorter than usual for age
• C. The urethral opening is along the dorsal surface of the penis
• D. The urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: In hypospadias, the urethral opening is located along the ventral surface of the penis. This congenital condition results in the urethral meatus opening on the underside of the penis, rather than at the tip. Choice A is incorrect as there is typically a urethral opening present, though in an abnormal location. Choice B is not a characteristic feature of hypospadias. Choice C is incorrect as the urethral opening in hypospadias is not along the dorsal surface but rather along the ventral surface of the penis.

5. An 8-year-old child diagnosed with meningitis is to undergo a lumbar puncture. What should the nurse explain is the purpose of this procedure?

• A. To measure the pressure of cerebrospinal fluid
• B. To obtain a sample of cerebrospinal fluid for analysis
• C. To relieve intracranial pressure
• D. To assess the presence of infection in the spinal fluid

Correct answer: B

Rationale: A lumbar puncture is performed to obtain a sample of cerebrospinal fluid for analysis. This fluid is then examined for signs of infection, bleeding, or other abnormalities. Measuring the pressure of cerebrospinal fluid is typically done during the procedure itself, but it is not the primary purpose of the lumbar puncture. While a lumbar puncture can indirectly help relieve intracranial pressure by removing excess cerebrospinal fluid, this is not its primary purpose. Assessing the presence of infection in the spinal fluid is part of the analysis that follows the collection of the sample, making it a secondary outcome of the procedure.

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