Nursing Elites

1. A child with a diagnosis of sickle cell anemia is admitted to the hospital with a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, the priority nursing intervention is administering pain medication to alleviate the severe pain associated with the crisis. While administering oxygen can help improve oxygenation, pain relief is crucial in managing the crisis. Monitoring fluid intake is important in sickle cell anemia but is not the most immediate intervention during a vaso-occlusive crisis. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can exacerbate pain and complications.

2. Which of the following signs or symptoms is more common in children than adults following head trauma?

• A. nausea and vomiting
• B. altered mental status
• C. tachycardia and diaphoresis
• D. changes in pupillary reaction

Correct answer: A

Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.

3. A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occurred. Which response by the nurse would be most appropriate?

• A. This condition is due to a genetic defect in the bones.
• B. It's most likely from how the baby was positioned in utero.
• C. They really don't know what causes this condition.
• D. There is probably an underlying deformity of the baby's hip.

Correct answer: B

Rationale: Metatarsus adductus is a condition characterized by the inward turning of the front part of the foot. It is often caused by the baby's position in the womb, leading to the foot adopting this position. Choice A is incorrect because metatarsus adductus is primarily related to positioning in utero rather than a genetic defect. Choice C is incorrect as there is an understanding of the common cause of this condition. Choice D is incorrect because metatarsus adductus specifically refers to a foot deformity, not a hip deformity.

4. What type of play does a caregiver expect when observing a toddler in a playroom with other children?

• A. Parallel
• B. Solitary
• C. Cooperative
• D. Competitive

Correct answer: A

Rationale: When observing a toddler in a playroom with other children, a caregiver would expect to witness parallel play. Parallel play is common among toddlers, where they play alongside but not directly with other children. This type of play is characterized by children engaging in similar activities near each other without interactive or cooperative play. Solitary play (Choice B) involves a child playing alone, while cooperative play (Choice C) involves children playing together towards a common goal. Competitive play (Choice D) involves activities where children compete against each other.

5. After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?

• A. Thickened formula 24 hours after surgery
• B. Withholding feedings for the first 24 hours
• C. Regular formula feeding within 24 hours after surgery
• D. Additional glucose feedings as desired after the first 24 hours

Correct answer: C

Rationale: After surgery for hypertrophic pyloric stenosis (HPS), it is appropriate to resume regular formula feeding within 24 hours postoperatively to promote recovery. Choice A, thickened formula after surgery, may be too heavy for the infant's digestive system at this early stage. Withholding feedings for the first 24 hours (Choice B) is not recommended as early feeding helps with recovery. Additional glucose feedings (Choice D) are not necessary and may not provide the balanced nutrition required after surgery.

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