Nursing Elites

1. Which patient is at greatest risk for papilledema?

• A. An elderly patient with cataracts and macular degeneration
• B. A male patient with hypothyroidism
• C. A male patient with hyperthyroidism
• D. An adolescent with a closed head injury

Correct answer: D

Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.

2. While caring for a four-year-old female patient who was severely burned in a house fire, how would you determine the extent of this child's burns?

• A. By using the Lund and Browder chart
• B. By using the Rule of Nines
• C. By using the Rule of Tens
• D. By using the Parkland Formula

Correct answer: A

Rationale: The correct answer is A: By using the Lund and Browder chart. The Lund and Browder chart is specifically designed to assess the extent of burns in children accurately, taking into account the variation in body proportions as children grow. This method provides a more precise estimation of the total body surface area affected by burns in pediatric patients. Choices B, C, and D are incorrect. The Rule of Nines is more suitable for adults, not children. The Rule of Tens is not a standard method for assessing burn extent, and the Parkland Formula is used to calculate fluid resuscitation requirements in burn patients, not to determine the extent of burns.

3. Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal?

• A. The client will be very thirsty.
• B. The client will complain of nausea.
• C. The client will need to urinate.
• D. The client will have moist skin.

Correct answer: D

Rationale: The correct answer is D. In this scenario, since Ben took his insulin but forgot to eat, he is at risk of developing hypoglycemia. Moist skin is a sign of hypoglycemia, which can occur when blood sugar levels drop too low. Thirstiness (choice A) is more commonly associated with hyperglycemia (high blood sugar levels). Nausea (choice B) and frequent urination (choice C) are not typical immediate signs of hypoglycemia caused by missing a meal after insulin administration.

4. You are caring for a patient with multiple trauma. Of all of these injuries and conditions, which is the most serious?

• A. A deviated trachea
• B. Gross deformity of a lower extremity
• C. Hematuria
• D. Decreased bowel sounds

Correct answer: A

Rationale: A deviated trachea is the most serious condition among the choices provided. It can indicate a tension pneumothorax, which is a life-threatening emergency requiring immediate intervention to prevent respiratory compromise. Choice B, a gross deformity of a lower extremity, while significant, is not as immediately life-threatening as a deviated trachea. Choice C, hematuria, may indicate kidney injury but is not as acutely life-threatening as a deviated trachea. Choice D, decreased bowel sounds, could indicate abdominal issues, but it is not as urgent or immediately life-threatening as a deviated trachea.

5. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take?

• A. Send an oxygen tank from the facility home with the client
• B. Instruct the client's family to contact the insurance provider about the oxygen equipment
• C. Contact social services about the delivery of the oxygen equipment
• D. Notify the provider about the delayed oxygen tank delivery

Correct answer: C

Rationale: The correct action for the nurse to take is to contact social services about the delivery of the oxygen equipment. This ensures that the necessary equipment is delivered to the client's home promptly. Choice A is incorrect because sending an oxygen tank from the facility is not a sustainable solution and may lead to legal and safety issues. Choice B is incorrect as contacting the insurance provider is not the appropriate course of action to address the delayed delivery. Choice D is also incorrect because notifying the provider about the delay may not directly lead to the timely delivery of the oxygen equipment.

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