Nursing Elites

1. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

2. Select the criteria that is accurately paired with its indication of birth weight or gestational age.

• A. Low birth weight: The neonate's weight is less than 1,500 g at the time of delivery.
• B. Appropriate for gestational age: The neonate's weight ranges from the 10th to the 90th percentile.
• C. Large for gestational age: The neonate's weight is above the 99th percentile.
• D. Small for gestational age: The neonate's weight is below the 20th percentile.

Correct answer: B

Rationale: Appropriate for gestational age (AGA) indicates a neonate's weight ranging from the 10th to the 90th percentile. This range signifies that the baby's weight is within the normal range for their gestational age. Choices A, C, and D provide inaccurate information about the criteria and do not correctly correspond to the indicated birth weight or gestational age. Low birth weight typically refers to a weight below 2,500 g, large for gestational age above the 90th percentile, and small for gestational age below the 10th percentile.

3. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (select one that does not apply)

• A. Reduce IV access
• B. Limit length of visits
• C. Restrict fluids to 1500 mL per day
• D. Conduct frequent neurologic checks

Correct answer: D

Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.

4. 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.

5. Which of the following is a nursing issue of concern today?

• A. Safe staffing
• B. Low workloads
• C. Increasing professional autonomy
• D. Improving salaries

Correct answer: A

Rationale: The correct answer is A: Safe staffing. Safe staffing is a critical issue in nursing today due to its impact on patient outcomes and nurse well-being. While low workloads (choice B) may seem beneficial, they can also indicate understaffing, leading to burnout and compromising patient care. Increasing professional autonomy (choice C) is generally viewed positively as it empowers nurses, and improving salaries (choice D) is important but may not directly address patient safety concerns related to staffing levels.

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