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. A nurse enters the hallway and discovers a visitor looking at a client's medical information on a computer. Which of the following actions should the nurse take first?

• A. Inform the care nurse that a visitor viewed a client's protected health information.
• B. Close the documentation program on the computer.
• C. Inform the visitor that the client's records are confidential.
• D. Find out which staff member left the documentation program on the screen.

Correct answer: B

Rationale: The correct first action for the nurse to take is to close the documentation program on the computer to prevent further unauthorized access to the client's medical information. Choice A is incorrect because the immediate concern is to secure the information first. Choice C, while important, can be addressed after securing the information. Choice D, finding out which staff member left the program open, is not the immediate priority when patient confidentiality is at risk.

3. Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select the one that does not apply.

• A. Your beta cells should be able to secrete insulin, but cannot.
• B. The endocrine function of your pancreas is to secrete insulin.
• C. Without insulin, you will develop ketoacidosis (DKA).
• D. The exocrine function of your pancreas is to secrete Estrogen.

Correct answer: D

Rationale: Type 1 diabetes is characterized by the inability of the beta cells in the pancreas to secrete insulin. Choice A is correct because it highlights the role of beta cells. Choice B is accurate as the endocrine function of the pancreas includes insulin secretion. Choice C is true as without insulin, ketoacidosis can develop. Choice D is incorrect as the exocrine function of the pancreas involves secreting digestive enzymes, not estrogen.

4. A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

• A. Inadequate food supply
• B. Low pain tolerance
• C. Limited social support
• D. Decreased self-esteem

Correct answer: A

Rationale: The nurse should address the inadequate food supply first as it directly impacts the client's health post-discharge. Proper nutrition is crucial for recovery after surgery, especially such as coronary artery bypass grafting. While low pain tolerance, limited social support, and decreased self-esteem are all important issues to address, addressing the client's nutritional needs is the priority in this scenario to ensure optimal recovery and healing.

5. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

• A. A client who reports right-sided flank pain and is diaphoretic
• B. A client who has active bleeding from a puncture wound of the left groin area
• C. A client who has a raised red skin rash on his arms, neck, and face
• D. A client who reports shortness of breath and left neck and shoulder pain

Correct answer: D

Rationale: The correct answer is D because shortness of breath with referred pain may indicate a serious condition, such as a cardiac event or pulmonary embolism, making this the highest priority. Option A, flank pain with diaphoresis, could suggest kidney-related issues but is not as immediately life-threatening as compromised breathing. Option B, active bleeding, though serious, can usually be controlled with proper interventions. Option C, a raised red skin rash, may indicate an allergic reaction but is not as urgent as respiratory distress with neck and shoulder pain.

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