Nursing Elites

1. A healthcare professional is preparing to administer an oral medication to a 4-year-old child. What is the best approach to gain the child's cooperation?

• A. Explain the importance of the medication to the child
• B. Allow the child to play with a favorite toy while taking the medication
• C. Offer a reward after the medication is taken
• D. Give the medication mixed with a small amount of the child's favorite food

Correct answer: B

Rationale: Allowing the child to play with a favorite toy while taking the medication is the best approach to gain cooperation. This strategy can help distract and calm the child during the medication administration process. Choice A may not be as effective with a young child who may not fully understand the explanation. Offering a reward (choice C) may reinforce negative behavior and create a dependency on rewards for cooperation. Giving the medication with food (choice D) may not always be appropriate and may not address the cooperation aspect.

2. A health care provider orders a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question the order?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas do not directly lead to loss of necessary nutrients. Choice C is incorrect as it focuses on emotional impact rather than physiological risks. Choice D is incorrect as shock from a sudden drop in temperature is not a common consequence of a tap water enema in this scenario.

3. A child has been diagnosed with gastroesophageal reflux disease (GERD). What position should the nurse recommend the child be placed in after eating?

• A. Supine
• B. Prone
• C. Semi-Fowler's
• D. Trendelenburg

Correct answer: C

Rationale: After eating, it is beneficial to place a child with GERD in a semi-Fowler's position. This position helps prevent reflux by keeping the child's head elevated above the stomach, reducing the chances of gastric contents flowing back into the esophagus. Placing the child supine (lying flat on their back) can worsen reflux symptoms by allowing gravity to work against the natural flow of gastric contents. Prone position (lying on the stomach) is not recommended due to the increased risk of aspiration. Trendelenburg position (feet elevated above head) is also inappropriate as it can lead to increased pressure on the abdomen, potentially worsening reflux symptoms.

4. What intervention best meets a major developmental need of a newborn in the immediate postoperative period?

• A. Giving a pacifier to the newborn
• B. Putting a mobile over the newborn’s crib
• C. Providing the newborn with a soft, cuddly toy
• D. Warming the newborn’s formula before feeding

Correct answer: A

Rationale: The correct answer is giving a pacifier to the newborn. Sucking is a natural reflex and a source of comfort for newborns, especially postoperatively. A pacifier can help meet their developmental needs by providing soothing comfort. Choices B, C, and D do not directly address the major developmental need related to the newborn's comfort and reflexes postoperatively. Putting a mobile over the crib, providing a cuddly toy, or warming formula, although potentially beneficial in other contexts, do not specifically target the developmental need of sucking for comfort. Offering a pacifier is a safe and effective way to address this developmental need in newborns.

5. A 2-year-old child with a diagnosis of hemophilia is admitted to the hospital. What should the nurse include in the care plan?

• A. Encourage participation in contact sports
• B. Use a soft toothbrush for oral care
• C. Administer nonsteroidal anti-inflammatory drugs
• D. Administer aspirin for pain

Correct answer: B

Rationale: Using a soft toothbrush helps to prevent bleeding in a child with hemophilia.

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