Nursing Elites

1. You are performing a neurological assessment of your adolescent patient. The patient has the Moro reflex. How should you interpret this neurological assessment finding?

• A. It is normal among adolescents.
• B. It indicates that the patient has an intact peripheral nervous system.
• C. It indicates that the patient has an intact central nervous system.
• D. It is not a normal finding.

Correct answer: D

Rationale: The Moro reflex, also known as the startle reflex, is typically present in infants up to around 4-6 months of age and is characterized by the infant's response to a sudden loss of support or loud noise. It is not a normal finding in adolescents or older individuals. Therefore, if an adolescent patient exhibits the Moro reflex during a neurological assessment, it is considered abnormal and warrants further evaluation. Choices A, B, and C are incorrect because the Moro reflex is not expected or normal among adolescents and does not specifically indicate the status of either the peripheral or central nervous system in this age group.

2. Which statement about glaucoma is true and accurate?

• A. Acute angle-closure glaucoma is an ocular emergency.
• B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision.
• C. Primary open-angle glaucoma leads to eye pain, nausea, and vomiting, blurry vision, and halos.
• D. Bubbles are implanted to protect the retina from glaucoma.

Correct answer: A

Rationale: The correct answer is A: 'Acute angle-closure glaucoma is an ocular emergency.' Acute angle-closure glaucoma is indeed considered an ocular emergency that requires immediate attention to prevent vision loss. Choice B is incorrect because acute angle-closure glaucoma commonly presents with symptoms like severe eye pain, headache, blurred vision, and halos around lights. Choice C is incorrect as these symptoms are more indicative of acute angle-closure glaucoma rather than primary open-angle glaucoma. Choice D is incorrect since bubbles are not typically used to protect the retina from glaucoma; treatment usually involves medications, laser therapy, or surgery to manage intraocular pressure.

3. What are the six levels of consciousness from the most to the least responsive level of consciousness? Number all six using 1 as the most conscious and 6 as the least conscious.

• A. Obtunded, Confused, Lethargic, Comatose, Stuporous, Alert
• B. Confused, Lethargic, Obtunded, Stuporous, Comatose, Alert
• C. Lethargic, Obtunded, Confused, Stuporous, Comatose, Alert
• D. Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose

Correct answer: D

Rationale: The correct order of the six levels of consciousness from most to least responsive is Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose. Choice A is incorrect because it starts with Obtunded, which is less responsive than Alert. Choice B is incorrect as it doesn't follow the correct order. Choice C is incorrect as Lethargic is more responsive than Obtunded. Therefore, the correct answer is D.

4. 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.

5. Select the types of pain that are accurately coupled with an example of it. Select all that are correct.

• A. Radicular pain: Pain shooting down the leg from a herniated disc
• B. Central neuropathic pain: Pain from nerve damage after a stroke
• C. Peripheral neuropathic pain: Pain from diabetic neuropathy in the feet
• D. Chronic pain: Pain lasting for more than 3-6 months

Correct answer: D

Rationale: The correct answer is D because chronic pain is characterized by lasting for a prolonged period, typically more than 3-6 months, and is not necessarily related to acute injuries like a stab wound to the chest. Choices A, B, and C are incorrect because they do not accurately match the type of pain with its corresponding example. Radicular pain is pain that radiates along the nerve path, often from a pinched nerve or herniated disc, not a broken bone. Central neuropathic pain arises from damage to the central nervous system, such as after a stroke, not a leg injury. Peripheral neuropathic pain is caused by damage to the peripheral nerves, such as in diabetic neuropathy, not a fractured leg bone.

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