Nursing Elites

1. The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?

• A. Heat only 10 oz or more.
• B. Do not thaw or heat breast milk in a microwave oven.
• C. Always leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Thawing or heating breast milk in a microwave is not recommended because it can create hot spots that may burn the infant and destroy essential nutrients.

2. A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

• A. Stimulate appetite
• B. Detect evidence of edema
• C. Minimize risk of infection
• D. Promote adherence to the antibiotic regimen

Correct answer: C

Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.

3. What should preoperative care of a newborn with an anorectal malformation include?

• A. Frequent suctioning
• B. Gastrointestinal decompression
• C. Feedings with sterile water only
• D. Supine position with head elevated

Correct answer: C

Rationale: Preoperative care for a newborn with an anorectal malformation should include feedings with sterile water only. This approach is important to avoid complications before surgery. Gastrointestinal decompression is necessary to prevent abdominal distention and potential aspiration, making choice B incorrect. Frequent suctioning and placing the newborn in a supine position with the head elevated are not typically part of the preoperative care protocol for an anorectal malformation, thus choices A and D are incorrect.

4. 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.

5. What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema?

• A. Place an ice pack on the scrotal area.
• B. Place the child in an upright sitting position.
• C. Elevate the scrotum with a rolled washcloth.
• D. Place a warm moist pack to the scrotal area.

Correct answer: C

Rationale: Elevating the scrotum with a rolled washcloth helps reduce edema by promoting fluid drainage. Ice packs are not recommended due to the risk of frostbite, and warm moist packs are not typically used for this purpose. An upright position does not specifically address the edema.

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