Nursing Elites

1. Which urinary diversion procedure is the least damaging to the body image of the adolescent?

• A. Urostomy
• B. Ileal conduit
• C. Nephrostomy
• D. Suprapubic placement

Correct answer: B

Rationale: The correct answer is B: Ileal conduit. The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. Unlike urostomy, nephrostomy, and suprapubic placement, the ileal conduit does not require an external appliance, which can be less damaging to an adolescent's body image.

2. Which medication is most likely to cause serious respiratory depression as a potential adverse reaction?

• A. Morphine
• B. Pentazocine
• C. Hydrocodone
• D. Nalmefene

Correct answer: A

Rationale: Morphine, as a strong opioid agonist, has the highest likelihood of causing serious respiratory depression due to its potent effects on the central nervous system. While Pentazocine and Hydrocodone can also cause respiratory depression, they are less likely to do so compared to morphine. Nalmefene, an opioid antagonist, is used to reverse respiratory depression caused by opioids rather than causing it.

3. Which statement most reflects the observation that the infant sleeps soundly, awakens on his own, and maintains a quiet alert state?

• A. This is atypical behavior and should be addressed
• B. The infant should remain on high alert when awake
• C. This shows the infant is making neurological gains
• D. The family is disrupting the child's sleep patterns

Correct answer: C

Rationale: A quiet alert state in infants indicates positive neurological development. It showcases the infant's ability to regulate sleep-wake cycles and maintain an optimal state for learning and interaction. Therefore, observing an infant who sleeps soundly, awakens on his own, and stays in a quiet alert state is a reassuring sign of neurological gains and healthy development. Choice A is incorrect as it misinterprets normal behavior as atypical. Choice B is incorrect as it suggests the infant should be on high alert, which is not developmentally appropriate. Choice D is incorrect as it falsely blames the family for disrupting the child's sleep patterns, whereas the scenario described indicates positive neurological growth.

4. Before administering a live virus vaccine to a patient taking a glucocorticoid medication, what action should the nurse take?

• A. Continue screening and administer the vaccine if appropriate
• B. Note the contraindication but administer the vaccine regardless
• C. Note the contraindication and clarify the order with the healthcare provider
• D. Withhold the vaccine and inform the department of health

Correct answer: C

Rationale: The correct action for the nurse to take when a patient on glucocorticoid medication is to note the contraindication and clarify the order with the healthcare provider. Glucocorticoids can suppress the immune response, potentially reducing the effectiveness of vaccines. Therefore, it is crucial to consult with the healthcare provider to assess the risks and benefits of administering a live virus vaccine in such circumstances. Administering a live virus vaccine to a patient taking glucocorticoids can increase the risk of developing a viral infection, making it essential to seek guidance from the healthcare provider before proceeding.

5. A healthcare professional is assessing a child who has a rotavirus infection. Which of the following is an expected manifestation?

• A. Constipation
• B. Vomiting
• C. Jaundice
• D. Abdominal pain

Correct answer: B

Rationale: Vomiting is a common manifestation of rotavirus infection in children. Rotavirus typically presents with symptoms such as watery diarrhea, vomiting, fever, and abdominal pain. Constipation, jaundice, and abdominal pain are less commonly associated with rotavirus infection in children.

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