Nursing Elites

1. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?

• A. It limits the chance of vomiting.
• B. It allows the feeding to be administered rapidly.
• C. The energy that would have been expended on sucking is conserved.
• D. The quantity of nutritional liquid can be regulated better than with a bottle.

Correct answer: C

Rationale: The correct answer is C: 'The energy that would have been expended on sucking is conserved.' Gavage feedings are necessary for infants with congenital heart defects as they help conserve the infant’s energy by eliminating the need for sucking, which can be taxing for infants with cardiac issues. Choice A is incorrect because gavage feedings are not primarily used to limit vomiting. Choice B is incorrect as the speed of administration is not the main reason for gavage feedings in this case. Choice D is incorrect because the regulation of the quantity of nutritional liquid is not the primary rationale for gavage feedings in infants with congenital heart defects.

2. What should the nurse suggest to a parent asking for help with a child experiencing night terrors?

• A. Encourage the child to talk about the night terrors.
• B. Establish a bedtime routine.
• C. Allow the child to sleep with the parents.
• D. Wake the child during the night.

Correct answer: B

Rationale: Establishing a bedtime routine is the most appropriate suggestion for a parent seeking help with a child experiencing night terrors. Bedtime routines can create a sense of security and predictability for the child, potentially reducing the frequency of night terrors. Encouraging the child to talk about the night terrors (Choice A) may not be effective during the episode as the child is usually not fully awake. Allowing the child to sleep with the parents (Choice C) may inadvertently reinforce the behavior and hinder the child’s ability to learn to self-soothe. Waking the child during the night (Choice D) may disrupt the sleep cycle and exacerbate the night terrors.

3. A 3-year-old child with a diagnosis of acute otitis media is being discharged. What should the nurse include in the discharge teaching?

• A. Encourage the child to drink plenty of fluids
• B. Encourage the child to eat a balanced diet
• C. Administer pain medication as needed
• D. Apply warm compresses to the affected ear

Correct answer: A

Rationale: The correct answer is to encourage the child to drink plenty of fluids. Encouraging adequate fluid intake helps to relieve symptoms and prevent dehydration in children with acute otitis media. A balanced diet (choice B) is important for overall health but is not specifically related to managing otitis media. While pain medication (choice C) may be prescribed, it should not be administered without medical advice. Applying warm compresses (choice D) is not typically recommended for acute otitis media as it can potentially worsen the condition by promoting bacterial growth.

4. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: The correct answer is C: Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta are the cardiac defects associated with Tetralogy of Fallot. In Tetralogy of Fallot, these specific abnormalities contribute to the classic features of the condition. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of Tetralogy of Fallot. Choice B describes transposition of the great arteries, not Tetralogy of Fallot. Choice D mentions an altered connection between the pulmonary artery and the aorta, which is not a defining characteristic of Tetralogy of Fallot.

5. What are general guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion?

• A. Examining the child in the parent's arms
• B. Palpating the painful area of the abdomen first
• C. Placing the child supine and palpating the abdomen
• D. Separating the child from the parent to ensure a reliable examination

Correct answer: A

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is important to examine the child in the parent's arms. This approach helps reduce the child's anxiety, provides comfort, and can facilitate a more accurate assessment. Palpating the painful area of the abdomen first (choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent to ensure a reliable examination (choice D) can further increase anxiety and hinder the assessment process. Therefore, examining the child in the parent's arms (choice A) is the most appropriate and effective approach in this scenario.

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