Nursing Elites

1. At what age range is it important to feed a baby in a more upright position and no longer in sidelying?

• A. 6-12 months
• B. 4-6 months
• C. 12-18 months
• D. Birth to 3 months

Correct answer: B

Rationale: Feeding a baby in a more upright position and no longer in sidelying is important around 4-6 months of age. At this stage, babies start developing better head and trunk control, which allows them to sit in a more upright position for feeding, promoting safer and more efficient swallowing and digestion. Choices A, C, and D are incorrect as feeding a baby in a more upright position typically starts around 4-6 months when the baby has gained more control over their head and trunk movements, making it safer and more effective for feeding.

2. A child with a history of seizures arrives in the emergency department (ED) in status epilepticus. Which is the priority nursing action?

• A. Take vital signs.
• B. Establish an intravenous line.
• C. Perform rapid neurologic assessment.
• D. Maintain a patent airway.

Correct answer: D

Rationale: When a child with a history of seizures presents in status epilepticus, the priority nursing action is to maintain a patent airway. This is crucial to ensure proper oxygenation and ventilation. While taking vital signs, establishing an intravenous line, and performing rapid neurologic assessment are important, maintaining a patent airway takes precedence. Hypoxia can lead to serious complications, making airway management the top priority to ensure the child's safety and prevent further deterioration.

3. The patient taking warfarin for prevention of deep vein thrombosis has an INR of 1.2. Which action by the nurse is most appropriate?

• A. Administer IV push protamine sulfate
• B. Continue with the current prescription.
• C. Prepare to administer Vitamin K
• D. Call healthcare provider to increase the dose

Correct answer: D

Rationale: An INR level of 1.2 is below the therapeutic range (2-3) for warfarin therapy. Therefore, the nurse should contact the healthcare provider to discuss the need for an increased dose to achieve the desired therapeutic range and prevent deep vein thrombosis effectively. Administering IV push protamine sulfate is used to reverse the effects of heparin, not warfarin. Continuing with the current prescription without addressing the subtherapeutic INR level may not effectively prevent deep vein thrombosis. Administering Vitamin K is indicated for warfarin overdose leading to excessive anticoagulation, not for a subtherapeutic INR level that is below the target range.

4. The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition?

• A. Hypertension
• B. Edema
• C. Diabetes insipidus
• D. Protection against postmenopausal osteoporosis

Correct answer: A

Rationale: Hydrochlorothiazide is primarily indicated for hypertension (HTN). Thiazides like hydrochlorothiazide are commonly the first-line treatment for hypertension. While hydrochlorothiazide can be used for edema, diabetes insipidus, and postmenopausal osteoporosis to some extent, its main use and efficacy lie in managing hypertension.

5. A nurse is providing dietary teaching to the parent of a school-age child with cystic fibrosis. Which of the following statements should the nurse make?

• A. You should offer your child high-protein meals and snacks throughout the day
• B. Your child should decrease dietary fats to less than 10% of their caloric intake
• C. Your child will need to take a 1-gram sodium chloride tablet daily throughout their lifetime
• D. You should calculate your child's carbohydrate needs based on their daily activities

Correct answer: A

Rationale: The parent should provide a well-balanced diet that is high in protein and calories for a child with cystic fibrosis. This diet helps meet the child's increased energy requirements. Offering high-protein meals and snacks throughout the day is essential to ensure adequate nutrition and energy intake for children with cystic fibrosis. Choices B, C, and D are incorrect because children with cystic fibrosis actually need a higher fat intake for proper absorption of fat-soluble vitamins, sodium chloride supplementation is not a general recommendation for all children with cystic fibrosis, and carbohydrate needs are usually based on maintaining adequate weight and growth rather than daily activities.

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