Nursing Elites

1. An appropriate method for administering oral medications that are bitter to an infant or small child should be to mix them with which?

• A. Bottle of formula or milk
• B. Any food the child is going to eat
• C. One teaspoon of something sweet-tasting such as jam
• D. Carbonated beverage, which is then poured over crushed ice

Correct answer: C

Rationale: Mixing bitter medication with a small amount of something sweet, like jam, can mask the taste effectively without diluting the medication too much. Mixing with milk or formula is not recommended as the child may refuse future feedings, and carbonated beverages are not suitable for infants.

2. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

3. Several types of long-term central venous access devices are used. What is a benefit of using an implanted port (e.g., Port-a-Cath)?

• A. You do not need to pierce the skin for access.
• B. It is easy to use for self-administered infusions.
• C. The patient does not need to limit regular physical activity, including swimming.
• D. The catheter cannot dislodge from the port even if the child plays with the port site.

Correct answer: C

Rationale: Implanted ports like the Port-a-Cath are fully implanted under the skin, allowing the child to maintain regular physical activities, including swimming, without the risk of dislodging the catheter. Piercing the skin is still required for access, and self-administration is more complex.

4. What statement best describes Hirschsprung disease?

• A. The colon has an aganglionic segment.
• B. It results in frequent evacuation of solids, liquid, and gas.
• C. The neonate passes excessive amounts of meconium.
• D. It results in excessive peristaltic movements within the gastrointestinal tract.

Correct answer: A

Rationale: Hirschsprung disease is characterized by the absence of ganglion cells in a segment of the colon, leading to a lack of peristalsis and obstruction. The other options do not accurately describe this condition.

5. The clinic nurse is teaching parents about physiologic anemia that occurs in infants. What statement should the nurse include about the cause of physiologic anemia?

• A. Maternally derived iron stores are depleted in the first 2 months.
• B. Fetal hemoglobin results in a shortened survival of red blood cells.
• C. The production of adult hemoglobin decreases in the first year of life.
• D. Low levels of fetal hemoglobin depress the production of erythropoietin.

Correct answer: B

Rationale: Physiologic anemia is caused by the transition from fetal to adult hemoglobin, with fetal hemoglobin having a shorter lifespan, leading to a temporary decrease in red blood cells.

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