Nursing Elites

1. When is cleft palate repair usually performed in children?

• A. A cleft palate cannot be repaired in children.
• B. Repair is usually performed by age 8 weeks.
• C. Repair is usually performed by 2 months of age.
• D. Repair is usually performed between 6 months and 2 years.

Correct answer: D

Rationale: Cleft palate repair timing is individualized based on the severity of the deformity and the child's size. Typically, cleft palate repair is performed between 6 months and 2 years of age. This age range allows for optimal outcomes and is often done before 12 months to promote normal speech development. Early closure of the cleft palate helps to facilitate speech development. Options A, B, and C are incorrect because a cleft palate can be repaired in children, and repair is usually performed between 6 months and 2 years of age, not at 8 weeks or 2 months.

2. A patient has a history of photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select one that doesn't apply

• A. Ciprofloxacin (Cipro)
• B. Sulfonamide
• C. Norfloxacin (Noroxin)
• D. Nitro-Dur patch

Correct answer: D

Rationale: Nitro-Dur patch is not associated with photosensitive reactions. It is used to prevent chest pain or angina, and common side effects include headache, lightheadedness, nausea, and flushing. Choices A, B, and C are known to cause photosensitive reactions. Ciprofloxacin (Cipro), Sulfonamides, and Norfloxacin (Noroxin) are drugs that are commonly associated with photosensitivity reactions. Patients taking these medications should be advised to avoid direct sunlight and use sun protection to prevent skin reactions.

3. A home care nurse instructs the mother of a 5-year-old child with lactose intolerance about dietary measures for her child. The nurse should tell the mother that it is necessary to provide which dietary supplement in the child's diet?

• A. Fats
• B. Zinc
• C. Protein
• D. Calcium

Correct answer: D

Rationale: In lactose intolerance, the inability to digest lactose, the sugar in dairy products, can lead to calcium deficiency if dairy products are removed from the diet. Calcium is crucial for bone health and other bodily functions, so alternative calcium sources like fortified non-dairy milks or leafy greens must be included to prevent deficiency. While fats and proteins are important nutrients, they are not typically deficient in lactose intolerance. Zinc, although an essential mineral, is not the primary concern in this case.

4. A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?

• A. The patient will be admitted to the medicine unit for observation and medication.
• B. The patient will be admitted to the day surgery unit for sclerotherapy.
• C. The patient will be admitted to the surgical unit and resection will be scheduled.
• D. The patient will be discharged home to follow-up with his cardiologist in 24 hours.

Correct answer: C

Rationale: A rapidly enlarging abdominal aortic aneurysm is at significant risk of rupture, which can be life-threatening. The standard treatment for a rapidly enlarging abdominal aortic aneurysm is surgical intervention to prevent rupture. Therefore, the appropriate action for the nurse to expect is that the patient will be admitted to the surgical unit, and resection will be scheduled. Observation and medication (Choice A) are not sufficient for a rapidly enlarging aneurysm, and sclerotherapy (Choice B) is not typically used for aortic aneurysms. Discharging the patient home (Choice D) would be inappropriate and dangerous given the risk of rupture.

5. The infant has a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, what intervention should the nurse plan?

• A. Cover the bladder with petroleum jelly gauze.
• B. Cover the bladder with a non-adhering plastic wrap.
• C. Apply sterile distilled water dressings over the bladder mucosa.
• D. Keep the bladder tissue dry by covering it with dry sterile gauze.

Correct answer: C

Rationale: Bladder exstrophy is a condition where the bladder is exposed and external to the body. To protect the exposed bladder tissue from drying out while allowing urine drainage, it is best to cover the bladder with a non-adhering plastic wrap. Using petroleum jelly gauze should be avoided as it can dry out, adhere to the mucosa, and damage delicate tissue upon removal. Applying sterile distilled water dressings can also dry out and cause damage when removed. Keeping the bladder tissue dry with sterile gauze is not ideal as maintaining a moist environment is important for tissue protection in this case.

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