Nursing Elites

1. Who is credited with the stages of cognitive development?

• A. Erikson
• B. Piaget
• C. Freud
• D. Lister

Correct answer: B

Rationale: Piaget is indeed credited with the stages of cognitive development. Jean Piaget, a renowned psychologist, proposed a theory of cognitive development that outlines distinct stages through which children develop intellectually. Erikson, Freud, and Lister are not associated with the stages of cognitive development. Erikson is known for his psychosocial stages, Freud for psychosexual stages, and Lister for contributions to the field of medicine.

2. Which of the following is considered normal for the neonate?

• A. Chest Circumference: 10 to 13 inches
• B. Length: 16 to 22 inches
• C. Weight: 1,500 to 4,000 g
• D. Head Circumference: 12.6 to 14.5 inches

Correct answer: D

Rationale: A normal head circumference for a neonate typically falls within the range of 12.6 to 14.5 inches. Choice A is incorrect because the chest circumference for a neonate is usually smaller. Choice B is incorrect as the length of a neonate is typically shorter. Choice C is incorrect as the weight of a neonate is usually measured in grams and falls within a different range.

3. Select the type of skeletal fracture that is correctly paired with its description.

• A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
• B. A pathological fracture: A fracture that results from some physical trauma.
• C. A greenstick fracture: This bends but does not fracture the bone.
• D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

Correct answer: D

Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.

4. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

5. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

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