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 type of practice is most similar to research-based practice?

• A. Best practices
• B. Evidence-based practice
• C. Benchmark practices
• D. Standard-based practice

Correct answer: B

Rationale: The correct answer is B: Evidence-based practice. Evidence-based practice relies on research to guide clinical decisions, mirroring the approach of research-based practice. Choice A, Best practices, refers to established methods or techniques that are widely accepted as superior. Choice C, Benchmark practices, typically involves setting standards or goals for performance comparison. Choice D, Standard-based practice, usually pertains to adhering to established norms or guidelines.

3. A nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the physician, and the physician prescribes dietary instructions based on the sodium level. Which food item should the nurse instruct the client to avoid?

• A. Peas
• B. Cauliflower
• C. Low-fat yogurt
• D. Processed oat cereals

Correct answer: D

Rationale: The correct answer is processed oat cereals. Processed oat cereals are often high in sodium content, which should be avoided in cases of hypernatremia. Peas, cauliflower, and low-fat yogurt are generally low in sodium and are not typically contraindicated in hypernatremia. Therefore, choices A, B, and C are incorrect.

4. A healthcare provider is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regards to client care?

• A. Occupational therapist
• B. Case manager
• C. Nutritionist
• D. Psychiatrist

Correct answer: B

Rationale: A case manager is the most appropriate interdisciplinary team member to consult for a client with anorexia nervosa. They can help coordinate care, resources, and communication between various healthcare professionals involved in the client's treatment. Consulting an occupational therapist (Choice A) may not directly address the primary concerns associated with anorexia nervosa. While nutritional therapists (Choice C) play a role in addressing nutritional needs, a case manager is better suited for overall care coordination. Mental health counselors (Choice D) focus more on emotional and psychological aspects, whereas a case manager coordinates practical aspects of care.

5. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

• A. Insulin must be injected because it needs to work quickly.
• B. Insulin can't be in a pill because it is destroyed in stomach acid.
• C. Have you talked to your doctor about taking pills instead?
• D. I know it is tough, but you will get used to the shots soon.

Correct answer: B

Rationale: The correct answer is B because insulin cannot be taken orally as it gets destroyed by stomach acid. Choice A is incorrect as the speed of action is not the reason why insulin can't be in pill form. Choice C is incorrect as it doesn't address the nature of insulin. Choice D is incorrect as it doesn't provide a factual reason why insulin can't be in pill form.

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