Nursing Elites

1. Which oxygen delivery system would provide the highest concentrations of oxygen to the client?

• A. Venturi mask
• B. Partial rebreather mask
• C. Non-rebreather mask
• D. Simple face mask

Correct answer: C

Rationale: The correct answer is the non-rebreather mask. This oxygen delivery system has a one-way valve that prevents exhaled air from entering the reservoir bag and one or more valves covering the air holes on the face mask itself to prevent the inhalation of room air but allow exhalation of air. When a tight seal is achieved around the mask, up to 100% of oxygen is available. Choice A, the Venturi mask, delivers precise oxygen concentrations but not as high as the non-rebreather mask. Choice B, the partial rebreather mask, allows the client to rebreathe some exhaled air, resulting in lower oxygen concentrations than the non-rebreather mask. Choice D, the simple face mask, delivers low to moderate oxygen concentrations and is not designed to provide the highest concentrations like the non-rebreather mask.

2. A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern?

• A. Bulging anterior fontanel
• B. Repeated vomiting
• C. Signs of sleepiness at 10 PM
• D. Inability to read short words from a distance of 18 inches

Correct answer: B

Rationale: Increased intracranial pressure after head trauma can lead to serious complications. Repeated vomiting is a concerning sign as it can indicate stimulation of the vomiting center within the brainstem due to increased pressure. This can be an early indicator of raised intracranial pressure and the need for urgent medical intervention. Bulging anterior fontanel may not be immediately apparent in a 4-year-old child and is more common in infants. Signs of sleepiness at a particular time of day are not specific to increased intracranial pressure. Inability to read short words from a distance of 18 inches may indicate vision problems but is not directly related to intracranial pressure.

3. The nurse is caring for a 7-year-old child with glomerulonephritis and is preparing to discuss the plan of care with the parents. In anticipating this encounter, the nurse recognizes that which is a common reaction of parents to the diagnosis of glomerulonephritis?

• A. Fear of the complicated treatment regimen
• B. Anger at the child for requiring hospitalization
• C. Guilt that they did not seek treatment more quickly
• D. Depression that the child may not be able to play sports

Correct answer: C

Rationale: Guilt is a common reaction of parents when their child is diagnosed with glomerulonephritis. Parents often blame themselves for not responding promptly to the child's initial symptoms or feel guilty for not seeking treatment sooner, thinking they could have prevented the development of glomerular damage. While fear of a complicated treatment regimen, anger at the child for hospitalization, and depression about the child not playing sports may be valid concerns, they are generally not as commonly observed as the feeling of guilt among parents in this situation.

4. A victim of domestic violence states, 'If I were better, I would not have been beaten.' Which feeling best describes what the victim may be experiencing?

• A. Fear
• B. Helplessness
• C. Self-blame
• D. Rejection

Correct answer: C

Rationale: The correct answer is self-blame. In this scenario, the victim is attributing the abuse to their own inadequacies or faults, thinking that if they were different, the abuse would not occur. This is a common response seen in victims of domestic violence, where they wrongly internalize the blame for the abuser's actions. Fear (Choice A) is a valid emotion, but in this case, the victim is not expressing fear but rather self-blame. Helplessness (Choice B) is also a common feeling in victims of domestic violence, but in this specific statement, the victim is demonstrating self-blame. Rejection (Choice D) does not accurately reflect the victim's statement and emotional response in the given scenario.

5. A child is suspected of suffering from intussusception. The nurse should be alert to which clinical manifestation of this condition?

• A. Tender, distended abdomen
• B. Presence of fecal incontinence
• C. Incomplete development of the anus
• D. Infrequent and difficult passage of dry stools

Correct answer: A

Rationale: Intussusception is an invagination of a section of the intestine into the distal bowel, and it is the most common cause of bowel obstruction in children aged 3 months to 6 years. A tender, distended abdomen is a typical clinical manifestation of intussusception. The presence of fecal incontinence is not a characteristic presentation of intussusception; it describes encopresis, which generally affects preschool and school-aged children but is not specific to intussusception. Incomplete development of the anus describes imperforate anus, a disorder diagnosed in the neonatal period, not intussusception. The infrequent and difficult passage of dry stools is characteristic of constipation, a common issue in children that can occur at any age, although it often peaks at 2 to 3 years old.

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