Nursing Elites

1. A healthcare professional is reviewing the laboratory report of an infant who is receiving treatment for severe dehydration. The professional should identify which of the following laboratory values indicates effectiveness of the current treatment?

• A. Potassium 2.9 mEq/L
• B. Sodium 140 mEq/L
• C. Urine specific gravity 1.035
• D. BUN 25 mg/dL

Correct answer: B

Rationale: A sodium level of 140 mEq/L within the expected reference range indicates effective treatment for dehydration. In dehydration, sodium levels are often elevated, so a normal sodium level suggests that the treatment is helping to restore the electrolyte balance in the infant's body.

2. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?

• A. Providing activities for the child on restricted activity
• B. Feeding the child a protein-restricted diet
• C. Carefully handling edematous extremities
• D. Observing the child for evidence of hypotension

Correct answer: A

Rationale: The most appropriate nursing intervention for a 7-year-old child with acute glomerulonephritis experiencing gross hematuria and bed rest is to provide activities for the child on restricted activity. It is important to keep the child engaged in light activities to prevent boredom and maintain some level of physical and mental well-being. Feeding a protein-restricted diet (Choice B) is not typically indicated in this scenario unless ordered by a healthcare provider to manage kidney function. Carefully handling edematous extremities (Choice C) is important in conditions like nephrotic syndrome but is not directly related to providing appropriate care for a child with acute glomerulonephritis. Observing the child for evidence of hypotension (Choice D) is important in general nursing care but is not the most immediate or specific intervention needed for a child with acute glomerulonephritis experiencing gross hematuria and bed rest.

3. A parent of an infant with gastroesophageal reflux is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?

• A. Offer the infant feedings every 2 hours.
• B. Position the infant upright after feedings.
• C. Feed the infant thickened formula.
• D. Place the infant in a prone position after feedings.

Correct answer: B

Rationale: Correct posture after feedings is crucial for an infant with gastroesophageal reflux to reduce the risk of regurgitation. Placing the infant upright helps prevent the backflow of stomach contents into the esophagus, minimizing symptoms of reflux.

4. 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.

5. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?

• A. Measuring intake and output
• B. Inserting a Foley catheter
• C. Covering the defect with sterile plastic wrap
• D. Palpating the bladder mass to ensure urine is expelled

Correct answer: C

Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.

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