Nursing Elites

1. A 9-week-old infant is scheduled for cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?

• A. Red blood cell count of 2.3 million/mm³
• B. White blood cell count of 10,000/mm³
• C. Weight gain of 2 pounds since birth
• D. Urine specific gravity is 1.011

Correct answer: A

Rationale: The correct answer is A because a low red blood cell count may indicate anemia, which could pose risks during surgery. Anemia can affect oxygen delivery to tissues, impacting wound healing and overall surgical outcomes. The other options, such as white blood cell count, weight gain, and urine specific gravity, are less critical for immediate surgical considerations. White blood cell count is more related to infection risk postoperatively rather than immediate surgical risk. Weight gain reflects good overall growth but does not impact the immediate surgical situation. Urine specific gravity is more indicative of hydration status rather than immediate surgical risk.

2. The caregiver is caring for a 3-year-old child with a diagnosis of gastroenteritis. The child has had several episodes of vomiting and diarrhea over the past 24 hours. What is the caregiver's priority assessment?

• A. Monitor the child's weight
• B. Assess the child's hydration status
• C. Evaluate the child's nutritional intake
• D. Check the child's temperature

Correct answer: B

Rationale: The correct answer is B: Assess the child's hydration status. In children with gastroenteritis, assessing hydration status is crucial as they are at risk of dehydration due to vomiting and diarrhea. Monitoring hydration helps prevent complications and guides appropriate interventions to maintain the child's fluid balance. Monitoring the child's weight (Choice A) is not the priority in this situation compared to assessing hydration status. Evaluating nutritional intake (Choice C) is important but not the priority when the child is at risk of dehydration. Checking the child's temperature (Choice D) is relevant but not the priority over assessing hydration status in a child with gastroenteritis.

3. The healthcare provider plans to screen only the highest risk children for scoliosis. Which group of children should the healthcare provider screen first?

• A. Girls between ages 10 and 14.
• B. Boys between ages 10 and 14.
• C. Boys and girls between 12 and 14.
• D. Boys and girls between 8 and 12.

Correct answer: A

Rationale: Corrected Question: The healthcare provider plans to screen only the highest risk children for scoliosis. Which group of children should the healthcare provider screen first? Girls between ages 10 and 14 are at the highest risk for scoliosis and should be screened first as they have a higher incidence of developing scoliosis during their adolescent growth spurt. Early detection and intervention can help prevent further complications associated with scoliosis. Boys between ages 10 and 14 (choice B) are not at the highest risk compared to girls in the same age group. Boys and girls between 12 and 14 (choice C) are at a lower risk compared to girls between ages 10 and 14. Boys and girls between 8 and 12 (choice D) are at a lower risk group compared to girls between ages 10 and 14.

4. The infant scheduled for reduction of intussusception passes a soft-formed brown stool the day before the procedure. What intervention should the nurse implement?

• A. Instruct the parents that the infant needs to be NPO.
• B. Notify the healthcare provider of the passage of brown stool.
• C. Obtain a stool specimen for laboratory analysis.
• D. Ask the parents about recent changes in the infant's diet.

Correct answer: B

Rationale: Notifying the healthcare provider is crucial when an infant scheduled for intussusception reduction passes a soft-formed brown stool as it may indicate spontaneous reduction of the intussusception. The healthcare provider needs to be informed to assess if the procedure is still necessary or if further evaluation is required. Instructing the parents that the infant needs to be NPO (nothing by mouth) is not the immediate action required in this situation. Obtaining a stool specimen for laboratory analysis is not necessary as the soft-formed brown stool is likely a result of the intussusception spontaneously reducing. Asking about recent changes in the infant's diet is not the most appropriate action when brown stool is passed before the procedure for intussusception reduction.

5. The nurse is caring for a 10-year-old child who is scheduled for surgery to repair a fractured femur. The child’s parent expresses concern about the child being afraid of the surgery. What is the nurse’s best response?

• A. Children at this age are usually not afraid of surgery
• B. It’s normal for your child to feel scared. Let’s talk about what to expect
• C. You should talk to the surgeon about your child’s fear
• D. Don’t worry, your child will be fine

Correct answer: B

Rationale: Acknowledging the child’s fear and providing information about what to expect can help alleviate anxiety.

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