Nursing Elites

1. Which anatomic malformations are associated with Tetralogy of Fallot?

• A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow
• B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow
• C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow
• D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow

Correct answer: D

Rationale: Tetralogy of Fallot is characterized by a combination of four heart defects: a sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow obstruction. This leads to mixing of oxygen-poor and oxygen-rich blood, resulting in cyanosis. Therefore, the correct answer is D. Choices A, B, and C are incorrect because they do not accurately describe the specific combination of anatomic malformations seen in Tetralogy of Fallot.

2. Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?

• A. Healthcare legislation that impacts nursing salaries in some states
• B. Workforce availability
• C. Aging of the baby boomers, resulting in a younger nursing workforce
• D. Population declines

Correct answer: B

Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.

3. What is the most common cause of HHNS?

• A. Insulin overdose
• B. Removal of the adrenal gland
• C. Undiagnosed, untreated hyperpituitarism
• D. Undiagnosed, untreated diabetes mellitus

Correct answer: D

Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.

4. Your client has a doctor's order that reads 'advance diet as tolerated'. This client has returned from the recovery room after an appendectomy and he states, 'I am hungry'. What would you offer this client to consume?

• A. Cheese and crackers
• B. Apple sauce
• C. Chicken broth
• D. A peanut butter sandwich

Correct answer: C

Rationale: Chicken broth is a suitable option for a post-appendectomy patient beginning to tolerate oral intake. It is clear liquid and easily digestible, making it a gentle choice for someone who has just returned from surgery. Cheese and crackers, apple sauce, and a peanut butter sandwich are not ideal options for an individual who needs to start with a light and easily digestible diet.

5. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

• A. A client who reports right-sided flank pain and is diaphoretic
• B. A client who has active bleeding from a puncture wound of the left groin area
• C. A client who has a raised red skin rash on his arms, neck, and face
• D. A client who reports shortness of breath and left neck and shoulder pain

Correct answer: D

Rationale: The correct answer is D because shortness of breath with referred pain may indicate a serious condition, such as a cardiac event or pulmonary embolism, making this the highest priority. Option A, flank pain with diaphoresis, could suggest kidney-related issues but is not as immediately life-threatening as compromised breathing. Option B, active bleeding, though serious, can usually be controlled with proper interventions. Option C, a raised red skin rash, may indicate an allergic reaction but is not as urgent as respiratory distress with neck and shoulder pain.

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