Nursing Elites

1. An important intervention for infants with developmental disabilities is to:

• A. Help parents realize their child will not develop further
• B. Stress the importance of early infant stimulation and intervention programs
• C. Have them institutionalized as soon as possible
• D. Have children reevaluated at 2 years of age to confirm the diagnosis

Correct answer: B

Rationale: The correct answer is B: Stress the importance of early infant stimulation and intervention programs. Early intervention programs are essential for infants with developmental disabilities as they can significantly impact the child's development and future outcomes. These programs provide necessary support and therapies to enhance the child's skills and abilities. Choice A is incorrect because it is crucial to provide hope and support to parents, emphasizing the potential for development and progress. Choice C is inappropriate and unethical as the first line of intervention. Institutionalization should only be considered in extreme cases where other options have been exhausted. Choice D is not the most crucial intervention at this stage. While reevaluation may be necessary, early intervention and support should be prioritized to maximize the child's developmental potential.

2. A 3-year-old child, previously potty-trained, becomes a bed-wetter again during a hospital stay. Which explanation should the nurse provide to the parents?

• A. “Your child is no longer potty-trained and will need to be retrained when she goes home.”
• B. “The child may have developed a bladder infection in the hospital. I will notify the doctor.”
• C. “Preschool children may regress in their behaviors when they are ill in the hospital but should return to normal when they go back home.”
• D. “Don’t worry about it, she is fine.”

Correct answer: C

Rationale: During a hospital stay, preschool children may exhibit regression in behaviors such as bed-wetting due to stress. It is important for parents to understand that this behavior is a common response to the hospital environment and should resolve once the child is back home. Therefore, the correct explanation for the nurse to provide to the parents is choice C. Choice A is incorrect because it inaccurately states that the child is no longer potty-trained. Choice B is incorrect as it assumes a medical issue without evidence. Choice D is incorrect as it dismisses the parents' concerns without addressing the underlying cause of the behavior.

3. What does the Hib conjugate vaccine protect against?

• A. Bacterial meningitis
• B. Epiglottitis
• C. Bacterial pneumonia
• D. All Correct

Correct answer: D

Rationale: The Hib conjugate vaccine is crucial for protecting children from several severe infections caused by Haemophilus influenzae type b, including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. Therefore, all the provided options are correct. Bacterial meningitis, epiglottitis, and bacterial pneumonia are serious conditions that the Hib vaccine effectively prevents, making choice D the correct answer. Choices A, B, and C are incorrect when considered individually as the Hib vaccine does not protect against only one specific infection; rather, it provides immunity against multiple diseases caused by Haemophilus influenzae type b.

4. What is the appropriate method for measuring the temperature of a 2-day-old neonate?

• A. Tympanic
• B. Oral
• C. Axillary
• D. Rectal

Correct answer: C

Rationale: For a 2-day-old neonate, the most suitable method to measure temperature is the axillary method. This approach is considered safe and appropriate for neonates, minimizing the risk of injury. Tympanic temperature measurement may not be as accurate in neonates due to their small ear canals. Oral temperature measurement is not recommended for neonates as they may not be able to hold a thermometer properly in their mouths. Rectal temperature measurement is invasive and carries a higher risk of injury and should be avoided unless absolutely necessary.

5. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

• A. Seizure disorder
• B. Narcotic withdrawal
• C. Placental insufficiency
• D. Meconium aspiration syndrome

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

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