Nursing Elites

1. The nurse is caring for a 1-month-old infant diagnosed with Hirschsprung’s disease. Which treatment measure should be included in the plan of care?

• A. Barium Enema
• B. Surgical removal of the affected section of bowel
• C. High-fiber diet
• D. Permanent colostomy

Correct answer: B

Rationale: The correct answer is B: Surgical removal of the affected section of bowel. Hirschsprung's disease is a congenital condition where a portion of the large intestine lacks nerve cells, leading to difficulties in passing stool. The definitive treatment for this condition is the surgical removal of the affected section of the bowel. Barium enema (Choice A) may be used for diagnosis but is not a treatment. A high-fiber diet (Choice C) is not effective in managing Hirschsprung's disease. A permanent colostomy (Choice D) is not the initial treatment for this condition in infants.

2. Which is an accurate description of homosexual (or gay-lesbian) families?

• A. A nurturing environment is lacking.
• B. The children become homosexual like their parents.
• C. The stability needed to raise healthy children is lacking.
• D. The quality of parenting is equivalent to that of nongay parents.

Correct answer: D

Rationale: Research shows that the quality of parenting in homosexual families is equivalent to that in heterosexual families, and children thrive in nurturing environments provided by same-sex parents.

3. What is the most appropriate intervention for a child with suspected acute appendicitis?

• A. Administer antibiotics
• B. Apply heat to the abdomen
• C. Encourage oral fluids
• D. Prepare for surgery

Correct answer: D

Rationale: The correct answer is D: Prepare for surgery. Acute appendicitis is a surgical emergency that requires prompt removal of the appendix to prevent complications like rupture and peritonitis. Administering antibiotics (choice A) may be part of the treatment plan but should not delay surgical intervention. Applying heat to the abdomen (choice B) is not recommended as it can worsen the inflammation of the appendix. Encouraging oral fluids (choice C) is generally beneficial, but the priority in acute appendicitis is surgical intervention.

4. At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant’s crib. What is the most appropriate response for the nurse to make?

• A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
• B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
• C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
• D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.

Correct answer: D

Rationale: Encouraging the baby to fall asleep in the crib while still awake can help establish healthy sleep habits and reduce night waking.

5. A teen with asthma asks the nurse why it is hard to breathe during an asthma attack. The nurse explains that exposure to a “trigger” results in which of these manifestations?

• A. Bronchodilation, muscle relaxation, and decreased mucus production
• B. Air trapping and hypo-inflation of the alveoli
• C. Air trapping and decreased blood flow to the upper airway
• D. Bronchoconstriction, airway inflammation, and excess mucus production

Correct answer: D

Rationale: The correct answer is D. Asthma triggers cause bronchoconstriction, airway inflammation, and increased mucus production, leading to difficulty breathing. This combination of manifestations results in narrowing of the airways, making it hard for the individual to breathe effectively. Choices A, B, and C are incorrect because during an asthma attack, bronchodilation, muscle relaxation, and decreased mucus production do not occur. Instead, the airways constrict, become inflamed, and produce excess mucus, contributing to the breathing difficulties experienced by individuals with asthma.

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