Nursing Elites

1. A neonate with a meningomyelocele is scheduled for surgery in the morning. Which nursing action is appropriate for this neonate?

• A. Applying a diaper to prevent contamination of the sac
• B. Positioning the newborn in a side-lying position
• C. Encouraging the mother to hold the newborn because she will not be able to pick him up after surgery
• D. Positioning the newborn in a prone position

Correct answer: D

Rationale: Positioning the newborn in a prone position is appropriate for a neonate with a meningomyelocele before surgery. Placing the newborn in this position helps prevent pressure on the sac, reducing the risk of damaging it and promoting optimal surgical outcomes. Applying a diaper (choice A) may not be recommended as it can increase pressure on the sac. Positioning the newborn in a side-lying position (choice B) or encouraging the mother to hold the newborn (choice C) are not ideal actions before surgery as they do not address the specific needs of a neonate with a meningomyelocele.

2. Why is it important to assess for in a child receiving prednisone to treat nephrotic syndrome?

• A. Infection
• B. Urinary retention
• C. Easy bruising
• D. Hypoglycemia

Correct answer: A

Rationale: When a child is receiving prednisone to treat nephrotic syndrome, it is crucial to assess for infection. Prednisone suppresses the immune system, making the child more vulnerable to infections. Since steroids can mask typical signs of infection, it is essential to look for subtle symptoms to ensure prompt treatment and prevent complications. Therefore, choices B, C, and D are incorrect as they are not directly related to the impact of prednisone therapy in nephrotic syndrome.

3. A healthcare professional is preparing to administer a measles, mumps, and rubella (MMR) vaccine to a 15-month-old child. Which of the following findings is a contraindication to the administration of this vaccine?

• A. Family history of egg allergy
• B. Currently taking antibiotics
• C. History of asthma
• D. Presence of rhinorrhea

Correct answer: B

Rationale: Taking antibiotics is a contraindication to receiving the MMR vaccine because antibiotics can potentially interfere with the effectiveness of the vaccine. It is essential to avoid administering the MMR vaccine while the child is on antibiotics to ensure the vaccine provides the intended protection.

4. Which menu choices for a child diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?

• A. Carrots and green, leafy vegetables
• B. Spaghetti and meat sauce with breadsticks
• C. Hamburger on a bun and cherry gelatin
• D. Chips, cold cuts, and canned foods

Correct answer: A

Rationale: Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia. Therefore, this choice requires further instruction by the nurse to prevent exacerbating the child's condition.

5. A child with croup has an increased PCO2, a decreased pH, and a normal HCO3 blood gas value. Which finding does the nurse report to the healthcare provider based on these data?

• A. Uncompensated metabolic alkalosis
• B. Uncompensated metabolic acidosis
• C. Uncompensated respiratory acidosis
• D. Uncompensated respiratory alkalosis

Correct answer: C

Rationale: The blood gas values indicate uncompensated respiratory acidosis. In respiratory acidosis, there is an increased PCO2, decreased pH, and a normal HCO3 level. This condition requires immediate attention to address the underlying respiratory problem causing the acidosis.

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