Nursing Elites

1. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?

• A. A low-fiber diet is not always required.
• B. Stress management may be helpful.
• C. Milk products may or may not be a contributing factor.
• D. Pantoprazole (a proton pump inhibitor) is not a first-line treatment.

Correct answer: B

Rationale: The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.

2. After 8 weeks in the neonatal intensive care unit, Chris will soon be discharged. His parents seem apprehensive and worry that he may still be in danger. What is this considered by the nurse?

• A. A common parental reaction
• B. Suggestive of maladaptation
• C. A reason to postpone discharge
• D. Suggestive of inadequate bonding

Correct answer: A

Rationale: Parents become apprehensive and worried as the time for discharge approaches, which is a common parental reaction. They often have concerns and insecurities about caring for their infant. The worry about potential dangers is a normal adaptive response reflecting the parents' concern for their child's well-being. It is essential for healthcare providers to acknowledge these feelings and support parents in gaining confidence in caring for their infant. Choices B, C, and D are incorrect because the parents' apprehension in this context is a typical emotional response and not indicative of maladaptation, a reason to postpone discharge, or inadequate bonding.

3. An infant requires surgery for repair of a cleft lip. An important priority of the preoperative nursing care is which?

• A. Initiating discharge teaching
• B. Performing baseline physical and behavioral assessment
• C. Observing for allergic reactions to preoperative antibiotics
• D. Determining whether this defect exists in other family members

Correct answer: B

Rationale: Performing a baseline physical and behavioral assessment is crucial to determine the infant's current health status and to identify any potential risks before surgery.

4. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

5. The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed?

• A. "We will try to preserve the adopted child's racial heritage."
• B. "We are glad we will be getting full medical information when we adopt our child."
• C. "We will make sure to have everyone realize this is our child and a member of the family."
• D. "We understand strangers may make thoughtless comments about our child being different from us."

Correct answer: C

Rationale: The statement about making sure others realize the child is part of the family may indicate a focus on external validation rather than on the child’s needs and identity, suggesting a need for further teaching.

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