Nursing Elites

1. What is the most common clinical manifestation of coarctation of the aorta?

• A. Clubbing of the digits
• B. Upper extremity hypertension
• C. Pedal edema and portal congestion
• D. Loud systolic ejection murmur

Correct answer: B

Rationale: The correct answer is B: Upper extremity hypertension. Coarctation of the aorta leads to increased blood pressure in the upper extremities. The pressure in the arms is typically 20 mm Hg higher than in the legs. Choice A, clubbing of the digits, is not a common clinical manifestation of coarctation of the aorta. Choice C, pedal edema, and portal congestion are more suggestive of conditions like heart failure rather than coarctation of the aorta. Choice D, loud systolic ejection murmur, can be heard in conditions like aortic stenosis, but it is not the most common clinical manifestation of coarctation of the aorta.

2. What should be included in the therapeutic management of iron deficiency anemia?

• A. Multivitamins
• B. Calcium
• C. Ferrous sulfate
• D. Iodine

Correct answer: C

Rationale: The correct answer is C: Ferrous sulfate. The therapeutic management of iron deficiency anemia should include iron supplementation, specifically with ferrous sulfate. This helps to replenish the body's iron stores. Multivitamins (choice A) may contain iron, but iron supplementation is more direct and effective. Calcium (choice B) and iodine (choice D) are not typically part of the primary treatment for iron deficiency anemia.

3. While performing a skin assessment on an older adult, the nurse notices a number of irregular round brownish-colored lesions on the client’s hands, arms, and face. On palpation, they are flat and slightly rough to the touch. Based on this assessment finding, which action should the nurse implement?

• A. Apply a topical antibiotic ointment.
• B. Monitor the lesions for changes.
• C. Advise the client to use sunscreen.
• D. Refer the client for a skin lesion biopsy.

Correct answer: D

Rationale: Referral for a skin biopsy is necessary to rule out potential malignancy of irregular skin lesions. Applying a topical antibiotic ointment (Choice A) is not indicated for irregular pigmented lesions. Monitoring the lesions for changes (Choice B) may delay appropriate intervention if malignancy is present. Advising the client to use sunscreen (Choice C) is important for sun protection but is not the priority when irregular lesions are present.

4. The mother of a child who has been diagnosed with varicella asks the nurse when the child can return to school. When is the child no longer contagious?

• A. When the fever dissipates
• B. After the incubation period
• C. When the lesions have healed
• D. When the lesions are crusted over

Correct answer: D

Rationale: The correct answer is D: 'When the lesions are crusted over.' Varicella is no longer contagious once the lesions are dry and crusted. This stage indicates that the active viral shedding has significantly decreased, reducing the risk of transmission. Choice A, 'When the fever dissipates,' is incorrect because the presence of fever does not necessarily correlate with the contagiousness of varicella. Choice B, 'After the incubation period,' is incorrect as the incubation period occurs before the onset of symptoms and is not relevant to determining contagiousness. Choice C, 'When the lesions have healed,' is incorrect as healed lesions can still be contagious if they are not crusted over.

5. 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.

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