Nursing Elites

1. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?

• A. Measuring intake and output
• B. Inserting a Foley catheter
• C. Covering the defect with sterile plastic wrap
• D. Palpating the bladder mass to ensure urine is expelled

Correct answer: C

Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.

2. A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient�s history should the nurse recognize as a contributing factor?

• A. Amoxicillin (Amoxil)
• B. Cimetidine (Tagamet)
• C. Metronidazole (Flagyl)
• D. Omeprazole (Prilosec)

Correct answer: B

Rationale: Cimetidine binds to androgen receptors, producing receptor blockade, which can cause enlarged breast tissue, reduced libido, and impotence. All these effects reverse when dosing stops. Amoxicillin, metronidazole, and omeprazole are not associated with gynecomastia.

3. A nurse is providing discharge teaching to the parent of a child who has juvenile idiopathic arthritis. Which of the following statements should the nurse include?

• A. Encourage the child to sleep for 8 hours each night.
• B. Perform range-of-motion exercises once per week.
• C. Give your child NSAIDs on a regular schedule.
• D. Apply heat to the child's affected joints twice daily.

Correct answer: C

Rationale: The nurse should instruct the parent to give the child NSAIDs on a regular schedule to maintain therapeutic levels and control pain.

4. During an assessment, which manifestation should a healthcare provider expect in an infant with pyloric stenosis?

• A. Bile-stained vomitus
• B. Distended abdomen
• C. Olive-shaped mass in the upper abdomen
• D. Painless, swollen joints

Correct answer: C

Rationale: Pyloric stenosis in infants typically presents with an olive-shaped mass in the upper abdomen due to hypertrophy of the pyloric muscle. This mass can often be palpated during an assessment and is a key characteristic of this condition. Bile-stained vomitus may be seen in conditions such as intestinal obstruction; a distended abdomen can be a nonspecific sign of various conditions, and painless, swollen joints are not typically associated with pyloric stenosis.

5. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?

• A. The dialysate is clear upon return.
• B. The volume of drained dialysate is less than the volume infused.
• C. The child is restless and eager to play.
• D. The child's vital signs remain consistent with those noted during infusion.

Correct answer: B

Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.

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