Nursing Elites

1. The parents of a newborn male with hypospadias want their child circumcised. The best response by the nurse is to inform them that

• A. Circumcision is delayed so the foreskin can be used for the surgical repair
• B. This procedure is contraindicated because of the permanent defect
• C. There is no medical indication for performing a circumcision on any child
• D. The procedure should be performed as soon as the infant is stable

Correct answer: A

Rationale: Circumcision is delayed so the foreskin can be used for the surgical repair. Even if mild hypospadias is suspected, circumcision is not done to save the foreskin for surgical repair if needed. Choice B is incorrect because circumcision is not contraindicated due to a permanent defect; it is delayed for potential surgical needs. Choice C is incorrect as there are situations where a circumcision may be indicated for medical or cultural reasons. Choice D is incorrect because circumcision for hypospadias-related repair is not done immediately but rather delayed to preserve the foreskin for potential reconstructive surgery.

2. Which of the following medications taken by the patient is least likely to cause urine discoloration?

• A. Sulfasalazine
• B. Levodopa
• C. Phenolphthalein
• D. Aspirin

Correct answer: D

Rationale: The correct answer is Aspirin. Aspirin is not known to cause urine discoloration. Sulfasalazine is associated with causing orange-yellow discoloration of urine. Levodopa can cause darkening of urine to a brown or black color. Phenolphthalein has been linked to pink or red discoloration of urine. Therefore, among the options provided, Aspirin is the medication least likely to cause urine discoloration.

3. During the admission assessment of a client with chronic bilateral glaucoma, which statement by the client would the nurse anticipate due to this condition?

• A. "I have constant blurred vision."?
• B. "I can't see on my left side."?
• C. "I have to turn my head to see my room."?
• D. "I have specks floating in my eyes."?

Correct answer: C

Rationale: In chronic bilateral glaucoma, peripheral visual field loss occurs due to elevated intraocular pressure, leading to the need to turn the head to compensate for the visual field deficit. This symptom is characteristic of advanced glaucoma. Choice A is incorrect as constant blurred vision is a common symptom but not specific to peripheral vision loss in glaucoma. Choice B is incorrect because specific visual field deficits are more common than complete loss on one side. Choice D is incorrect as seeing floaters (specks floating in the eyes) is associated with other eye conditions like posterior vitreous detachment, not glaucoma.

4. Which of the following glands found in the skin secretes a liquid called Sebum?

• A. Apocrine Glands
• B. Sebaceous Glands
• C. Lacrimal Glands
• D. Sweat Glands

Correct answer: B

Rationale: Sebum is a liquid secreted by glands in the skin known as sebaceous glands. Sebum's primary function is to lubricate the skin and help maintain its integrity. Apocrine glands secrete a different type of sweat that is odorless but can develop an odor when combined with bacteria on the skin. Lacrimal glands produce tears to keep the eyes moist, and sweat glands secrete sweat to regulate body temperature through evaporation. Therefore, the correct answer is Sebaceous Glands because they specifically secrete sebum, distinguishing them from the other gland types mentioned.

5. A patient is suspected to have sustained a spinal cord injury. What best describes the overarching principles used to guide the care for this type of condition?

• A. Immobilize the cervical area to prevent further injury
• B. Monitor the patient's level of consciousness to prevent neurologic deterioration
• C. Help the patient with activities of daily living and provide emotional and physical support to help them adjust to their injury
• D. Facilitate tissue perfusion to the spinal cord while maintaining airway and breathing

Correct answer: D

Rationale: The correct answer is to facilitate tissue perfusion to the spinal cord while maintaining airway and breathing. In the acute phase of a spinal cord injury, ensuring proper tissue perfusion to the spinal cord is crucial to prevent further damage. Maintaining airway, breathing, and circulation is essential in guiding the overall care for a patient with a spinal cord injury. Choices A, B, and C, while important in certain aspects of care, are not the overarching principles that guide the immediate management of a suspected spinal cord injury.

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