Nursing Elites

1. When assessing a newborn infant with low set ears, short palpebral fissures, flat nasal bridge, and an indistinct philtrum, a priority maternal assessment by the nurse should be to ask about

• A. Alcohol use during pregnancy
• B. Usual nutritional intake
• C. Family genetic disorders
• D. Maternal and paternal ages

Correct answer: A

Rationale: The correct answer is A: Alcohol use during pregnancy. The physical features mentioned are indicative of fetal alcohol syndrome, a condition caused by maternal alcohol consumption during pregnancy. It is crucial for the nurse to inquire about alcohol use as it can help in diagnosing and managing the infant's condition. Choices B, C, and D are incorrect as they are not directly associated with the physical findings described in the newborn, which specifically point towards a potential history of alcohol exposure during pregnancy.

2. When the nurse identifies what appears to be ventricular tachycardia on the cardiac monitor of a client being evaluated for possible myocardial infarction, the first action the nurse should perform is to

• A. Begin cardiopulmonary resuscitation
• B. Prepare for immediate defibrillation
• C. Notify the 'Code' team and healthcare provider
• D. Assess airway, breathing, and circulation

Correct answer: D

Rationale: The correct first action for the nurse to take when identifying what appears to be ventricular tachycardia in a client being evaluated for possible myocardial infarction is to assess the client's airway, breathing, and circulation. This step is crucial to determine the client's stability and the need for immediate intervention. Beginning cardiopulmonary resuscitation or preparing for immediate defibrillation without first assessing the airway, breathing, and circulation could delay potentially life-saving interventions. Notifying the 'Code' team and healthcare provider should come after ensuring the client's immediate needs are addressed.

3. A client comes into the community health center upset and crying stating, “I will die of cancer now that I have this disease.” And then the client hands the nurse a paper with one word written on it: 'Pheochromocytoma.' Which response should the nurse state initially?

• A. 'Pheochromocytomas usually aren't cancerous (malignant). But they may be associated with cancerous tumors in other endocrine glands such as the thyroid (medullary carcinoma of the thyroid).'
• B. 'This problem is diagnosed by blood and urine tests that reveal elevated levels of adrenaline and noradrenaline.'
• C. 'Computerized tomography (CT) or magnetic resonance imaging (MRI) are used to detect an adrenal tumor.'
• D. 'You probably have had episodes of sweating, heart pounding, and headaches.'

Correct answer: A

Rationale: The correct initial response for the nurse to provide in this situation is to offer reassurance. Stating that 'Pheochromocytomas usually aren't cancerous (malignant)' helps to alleviate the client's anxiety and fear of having cancer. This response also establishes a foundation for further discussion about the condition, allowing the nurse to address the client's concerns and provide accurate information. Choice B is incorrect as it focuses solely on the diagnostic tests for pheochromocytoma but does not address the client's emotional distress. Choice C is incorrect as it discusses imaging modalities without directly addressing the client's concerns. Choice D is also incorrect as it assumes symptoms without first addressing the client's emotional state and fear of cancer.

4. A traditional plant used to lower uric acid is used by Rosario, a 55-year-old client with rheumatism. This herbal plant called “ulasimang bato” is commonly known as:

• A. Lagundi
• B. Pancit pacitan
• C. Bayabas
• D. Sambong

Correct answer: B

Rationale: The correct answer is B, Pancit pacitan (Peperomia pellucida), which is known for its uric acid-lowering properties. Ulasimang bato is the local name for this traditional plant. Choices A, C, and D are incorrect. Lagundi (Choice A) is commonly used for its antitussive and anti-asthmatic properties. Bayabas (Choice C) refers to guava, which is known for its high vitamin C content and other health benefits. Sambong (Choice D) is used for its diuretic properties and is often utilized for kidney health.

5. Which of these statements by the nurse is incorrect to use to reinforce information about cancers to a group of young adults?

• A. "You can reduce your risk of this serious type of stomach cancer by eating lots of fruits and vegetables, limiting red meat, and avoiding nitrate-containing foods."
• B. "Prostate cancer is the most common cancer in American men, impacting sexuality and life quality."
• C. "Colorectal cancer is the second-leading cause of cancer-related deaths in the United States."
• D. "Lung cancer is the leading cause of cancer deaths in the United States. However, it is the most preventable of all cancers."

Correct answer: A

Rationale: The corrected statement in choice A emphasizes limiting red meat for the prevention of stomach cancer, which is more accurate than avoiding all meats. By focusing on red meat specifically, it provides clearer guidance to young adults. Choice B is not the correct answer as it provides accurate information about prostate cancer being the most common cancer in American men and its impact on sexuality and life quality. Choice C is also a valid statement, correctly highlighting colorectal cancer as the second-leading cause of cancer-related deaths in the United States. Choice D provides accurate information about lung cancer being the leading cause of cancer deaths in the United States and emphasizes its preventability among cancers, making it a valid statement for reinforcing information about cancers to young adults.

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