Nursing Elites

1. What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany?

• A. Metabolic acidosis
• B. Respiratory alkalosis
• C. Metabolic and respiratory acidosis
• D. Metabolic and respiratory alkalosis

Correct answer: D

Rationale: Both metabolic and respiratory alkalosis can cause overexcitability and nervous system stimulation due to a decrease in ionized calcium levels, which can cause symptoms such as tetany and paresthesias. Acidosis typically has the opposite effect, leading to depression of the nervous system.

2. Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

• A. Avoid asking the child to make choices.
• B. Plan for a teaching session to last about 20 minutes.
• C. Demonstrate on a doll how the procedure will be done.
• D. Show the necessary equipment without allowing child to handle it.

Correct answer: C

Rationale: Demonstrating on a doll helps the toddler understand what will happen in a non-threatening way, making the procedure less intimidating. Long teaching sessions or avoiding choices can increase anxiety.

3. What is a classic sign of congenital hypothyroidism in newborns?

• A. Jaundice
• B. Hypothermia
• C. Prolonged jaundice
• D. Excessive crying

Correct answer: C

Rationale: Prolonged jaundice is a classic sign of congenital hypothyroidism in newborns. In congenital hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to symptoms like jaundice, poor feeding, constipation, and lethargy. While jaundice itself is a common condition in newborns, the term 'prolonged jaundice' specifically points towards the underlying thyroid issue. Hypothermia and excessive crying are not typically associated with congenital hypothyroidism.

4. Which is considered a block to effective communication?

• A. Using silence
• B. Using clichés
• C. Directing the focus
• D. Defining the problem

Correct answer: B

Rationale: Using clichés is a communication block because it can come across as dismissive or insincere, hindering meaningful dialogue.

5. A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)

• A. Dialysis
• B. All below
• C. Sodium bicarbonate
• D. Glucose 50% and insulin

Correct answer: A

Rationale: Calcium gluconate, sodium bicarbonate, and glucose with insulin are used as temporary measures to rapidly reduce serum potassium levels. They help shift potassium into cells and stabilize the heart but do not remove potassium from the body like dialysis does.

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