Nursing Elites

1. What is the hallmark sign of intussusception?

• A. Mucus-like stools
• B. Currant jelly-like stools
• C. Tarry, black stools
• D. Green, soft stools

Correct answer: B

Rationale: The hallmark sign of intussusception is currant jelly-like stools, which result from the mixture of blood and mucus in the stool due to the sloughing of intestinal mucosa. Mucus-like stools (Choice A) are not typically associated with intussusception. Tarry, black stools (Choice C) are characteristic of gastrointestinal bleeding higher up in the gastrointestinal tract, such as from a peptic ulcer. Green, soft stools (Choice D) are more indicative of rapid transit through the intestines, possibly due to dietary factors or infections such as gastroenteritis.

2. Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. What is the best explanation for the nurse to provide as to why a second medication has been added?

• A. Methotrexate slows the disease progression while aspirin controls the symptoms.
• B. Methotrexate helps to reduce the side effects of aspirin.
• C. Methotrexate has fewer harmful side effects than aspirin.
• D. Methotrexate enhances the effect of aspirin.

Correct answer: A

Rationale: The correct answer is A. Methotrexate is a disease-modifying antirheumatic drug (DMARD) that slows the progression of rheumatoid arthritis (RA), while aspirin helps control symptoms such as pain and inflammation. Therefore, the combination of methotrexate and aspirin is beneficial in managing RA by addressing both disease progression and symptom control. Choices B, C, and D are incorrect because methotrexate is not added to reduce the side effects of aspirin, has different side effects compared to aspirin, and does not enhance the effect of aspirin.

3. When assessing an adolescent with depression, what is the most important question for the nurse to ask?

• A. What is causing your feelings of depression?
• B. Have you ever thought about suicide?
• C. What actions can we take to improve your mood?
• D. Would you like your friends to come over?

Correct answer: B

Rationale: The correct answer is B: 'Have you ever thought about suicide?' When assessing an adolescent with depression, it is crucial to ask direct questions about suicidal thoughts. This helps determine the severity of the situation, especially if the person has considered or planned to harm themselves. Choice A is not as direct and specific to suicidal ideation. Choice C focuses on improving mood rather than assessing the risk of harm. Choice D is unrelated to assessing suicidal ideation and the severity of the depression.

4. The family of a newly admitted child with cystic fibrosis is educated by the nurse that the treatment will be centered on what therapy?

• A. Chest physiotherapy
• B. Mucus-drying agents
• C. Prevention of diarrhea
• D. Insulin therapy

Correct answer: A

Rationale: The correct answer is A: Chest physiotherapy. In cystic fibrosis, chest physiotherapy and aerosol medications are fundamental components of treatment to help clear mucus from the lungs, reduce the risk of infections, and improve breathing. Mucus-drying agents (Choice B) are not typically used in the treatment of cystic fibrosis. Prevention of diarrhea (Choice C) is not a primary focus in the treatment of cystic fibrosis. Insulin therapy (Choice D) is not relevant to cystic fibrosis, as it is a treatment for diabetes.

5. The nurse is triaging clients who have been injured during a tornado. Which client requires immediate action?

• A. A young male with a minor laceration on his forearm.
• B. An elderly woman with a dislocated shoulder who is calm.
• C. A middle-aged female with a broken humerus who is unable to follow commands and is crying.
• D. A teenager with abrasions and a bruised knee.

Correct answer: C

Rationale: The middle-aged female with a broken humerus who is unable to follow commands and is crying requires immediate action. These symptoms indicate a possible head injury or severe emotional distress that need urgent attention. Choice A is not as urgent since a minor laceration can be addressed after more critical cases. Choice B, although having a dislocated shoulder, is stable, as the client is calm. Choice D presents with minor injuries that can wait while more critical cases are addressed.

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