Nursing Elites

1. You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:

• A. 8 to 12 months of age.
• B. 20 to 24 months of age.
• C. 16 to 20 months of age.
• D. 12 to 16 months of age.

Correct answer: A

Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.

2. Which of the following is an example of a chronic disease?

• A. Common cold
• B. Influenza
• C. Diabetes
• D. Food poisoning

Correct answer: C

Rationale: Diabetes is classified as a chronic disease because it is a long-term condition that requires ongoing management. Choices A, B, and D, which are the common cold, influenza, and food poisoning, are acute illnesses that typically resolve on their own without long-lasting implications.

3. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for further evaluation and possible intervention?

• A. A client who is at 28 weeks gestation and has a negative Coombs titer
• B. A client who is 39 weeks of gestation and has a negative contraction stress test
• C. A client who is at 35 weeks of gestation and has a biophysical profile of 6
• D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1

Correct answer: C

Rationale: A biophysical profile of 6 at 35 weeks of gestation indicates a need for further evaluation and possible intervention. A negative Coombs titer at 28 weeks gestation (Choice A) is within normal limits. A negative contraction stress test at 39 weeks gestation (Choice B) is expected as the pregnancy nears term. An L/S ratio of 2:1 at 37 weeks of gestation (Choice D) is consistent with fetal lung maturity.

4. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

5. A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?

• A. Elevating the head of the client's bed to 30 degrees during mealtime
• B. Withholding fluids until the end of the meal
• C. Providing a 10-minute rest period prior to meals
• D. Instructing the client to place her chin toward her chest when swallowing

Correct answer: D

Rationale: The correct technique for a client with dysphagia is to instruct them to place their chin toward their chest when swallowing. This action helps to close off the airway during swallowing, reducing the risk of aspiration. Elevating the head of the client's bed to 30 degrees during mealtime helps prevent aspiration, but this is not the responsibility of the AP. Withholding fluids until the end of the meal can lead to dehydration and is not a recommended practice. Providing a 10-minute rest period prior to meals is not specifically related to improving swallowing safety for clients with dysphagia.

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