Nursing Elites

1. An infant is suspected of having esophageal atresia/tracheoesophageal fistula. While waiting for the pediatrician to see the infant, which action should the nurse take?

• A. Position the infant with the head of the bed slightly elevated
• B. Allow the infant to bond with the mother in her room
• C. Offer the infant breastfeeding instead of formula feeding
• D. Wrap the infant in blankets and place in a crib by the viewing window

Correct answer: A

Rationale: Positioning the infant with the head of the bed elevated helps to prevent aspiration and manage secretions until further treatment can be provided. Choice B is incorrect as the priority is ensuring the infant's safety and health, not immediate bonding. Choice C is incorrect as breastfeeding may worsen the condition. Choice D is incorrect as it does not address the potential risk of aspiration associated with esophageal atresia/tracheoesophageal fistula.

2. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

• A. 50th percentile
• B. 75th percentile
• C. 80th percentile
• D. 95th percentile

Correct answer: D

Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.

3. What is known as providing families with information on normal growth and development and nurturing child-rearing practices before the child enters that stage of development?

• A. Holistic nursing
• B. Evidence-based practice
• C. Morbidity
• D. Anticipatory guidance

Correct answer: D

Rationale: Anticipatory guidance is the process of providing parents with information about expected developmental milestones and how to address common issues that may arise during different stages of their child's growth. This proactive approach helps parents prepare for and support their child's development. Holistic nursing (choice A) refers to a comprehensive and integrated approach to healthcare that considers the whole person. Evidence-based practice (choice B) involves making clinical decisions based on the best available evidence. Morbidity (choice C) refers to the prevalence of a disease in a population.

4. An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?

• A. Giving half of the solution and then repeating the other half in 1 hour
• B. Mixing with a flavorful beverage in an opaque container with a straw
• C. Serving it in a clear plastic cup so the child can see how much has been drunk
• D. Administering it through a nasogastric tube because the child will not drink it because of the taste

Correct answer: B

Rationale: Mixing activated charcoal with a flavorful beverage in an opaque container can help mask the taste and encourage the child to ingest it. Using an opaque container can prevent the child from seeing the unappealing appearance of the charcoal mixture, increasing compliance.

5. Which laboratory value at the time of diagnosis should the nurse anticipate would determine the worst prognosis for a child with leukemia?

• A. Slow response to chemotherapy
• B. Platelets of 150,000/mcL
• C. Leukocytes less than 10,000/mcL
• D. Leukocytes of 275,000/mcL

Correct answer: D

Rationale: A high white blood cell count (leukocytes of 275,000/mcL) at diagnosis is associated with a worse prognosis in leukemia because it indicates a more aggressive disease with a higher tumor burden. Slow response to chemotherapy (choice A) is a consequence of the aggressive disease and not a determining factor at diagnosis. Platelets of 150,000/mcL (choice B) and leukocytes less than 10,000/mcL (choice C) are within normal ranges and not indicative of a worse prognosis in leukemia.

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