Nursing Elites

1. The mother of a 9-month-old girl provides the practical nurse with information about her daughter's diet. Which statement by the mother may indicate why the infant has been diagnosed with iron-deficiency anemia?

• A. She almost never drinks sugary water.
• B. She has been on whole milk for 7 months.
• C. She likes to chew on bread as a snack.
• D. She doesn't like to eat peaches or pears.

Correct answer: B

Rationale: The correct answer is B. Infants should not be given cow's milk before 1 year of age as it can interfere with iron absorption and lead to anemia. Choice A is incorrect as avoiding sugary water is actually a good practice. Choice C is unrelated to iron-deficiency anemia. Choice D, not liking peaches or pears, is also not directly related to iron-deficiency anemia.

2. The practical nurse is reinforcing information about Lyme disease prevention with a client who is preparing for a camping trip with family. Which statement by the client informs the nurse that the client understands the instruction?

• A. I'll make sure my son wears dark clothing on his hike.
• B. I'll get a prescription for amoxicillin to take with us.
• C. We should all get the Lyme disease vaccine before our trip.
• D. We will wear long pants and long-sleeved shirts in the woods.

Correct answer: D

Rationale: The correct answer is D. Wearing long pants and long-sleeved shirts is an effective preventive measure against tick bites, which reduces the risk of contracting Lyme disease. This attire helps to minimize skin exposure to ticks, thereby decreasing the chances of a tick attaching and transmitting the disease-causing bacteria.

3. A mother brings her 8-month-old baby boy to the clinic because he has been vomiting and having diarrhea for the last 3 days. Which assessment is most important for the nurse to make?

• A. Assess the infant's abdomen for tenderness
• B. Determine if the infant has been exposed to a virus
• C. Measure the infant’s pulse
• D. Evaluate the infant’s cry

Correct answer: C

Rationale: The most crucial assessment in this scenario is to measure the infant's pulse. Pulse measurement is essential to evaluate the severity of dehydration, which can be a significant concern in a baby experiencing vomiting and diarrhea for several days. Assessing the abdomen for tenderness may provide information on potential causes of symptoms but is not as urgent as monitoring hydration status. Determining exposure to a virus is important for infection control but does not directly address the immediate issue of dehydration. Evaluating the infant's cry, although a form of communication, does not provide critical information regarding the baby's physiological status in this situation.

4. When should the surgical correction of hypospadias in a newborn infant typically be done?

• A. Repair should be done by one month to prevent bladder infection.
• B. To form a proper urethra repair, it should be done after sexual maturity.
• C. Repairs typically should be done before the child is potty trained.
• D. Delaying the repair until school age reduces castration fears.

Correct answer: C

Rationale: Surgical repairs for hypospadias are typically recommended to be performed before the child is potty trained. This timing helps in avoiding complications, ensures better outcomes, and makes the surgical process smoother. Early correction also minimizes the psychological impact on the child regarding genital differences and can improve long-term psychological well-being. Choices A, B, and D are incorrect because repairing hypospadias at one month to prevent bladder infection, after sexual maturity to form a proper urethra, or delaying the repair until school age to reduce castration fears are not the standard recommendations. The optimal timing for surgical correction is before the child is potty trained to achieve the best results and psychological outcomes.

5. In a 7-year-old child with a history of asthma experiencing an acute asthma exacerbation and displaying wheezing and the use of accessory muscles to breathe, what is the nurse’s priority intervention?

• A. Administer a nebulized bronchodilator
• B. Obtain an arterial blood gas
• C. Start the child on oxygen therapy
• D. Notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to administer a nebulized bronchodilator. During an acute asthma exacerbation in a child with wheezing and increased work of breathing, the priority intervention is to provide immediate bronchodilation to dilate the airways, relieve bronchospasm, and improve breathing. This intervention aims to manage the acute asthma attack effectively and prevent further respiratory distress. Obtaining an arterial blood gas, starting oxygen therapy, or notifying the healthcare provider are important actions, but administering a bronchodilator takes precedence in addressing the acute respiratory compromise.

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