Nursing Elites

1. The nurse is caring for a child receiving chemotherapy with the following orders: Zantac 70 mg IV in normal saline 30 mL to infuse over 30 minutes. The nurse should set the infusion pump to deliver how many mL/hour?

• A. 60 mL/hour
• B. 45 mL/hour
• C. 30 mL/hour
• D. 15 mL/hour

Correct answer: A

Rationale: The correct answer is A: 60 mL/hour. The total volume to be infused is 30 mL over 30 minutes. To calculate the infusion rate in mL/hour, divide the total volume by the total time in hours. In this case, 30 mL / 0.5 hours = 60 mL/hour. Choice B, 45 mL/hour, is incorrect as it does not correspond to the calculated infusion rate. Choices C and D, 30 mL/hour and 15 mL/hour respectively, are also incorrect based on the calculation.

2. During an otoscopic examination on an infant, in which direction is the pinna pulled?

• A. Up and back
• B. Up and forward
• C. Down and back
• D. Down and forward

Correct answer: C

Rationale: For infants, the pinna is pulled down and back to straighten the ear canal and allow proper visualization of the tympanic membrane during otoscopic examination.

3. Examination of the abdomen is performed correctly by the nurse in which order?

• A. Inspection, palpation, percussion, and auscultation
• B. Inspection, percussion, auscultation, and palpation
• C. Palpation, percussion, auscultation, and inspection
• D. Inspection, auscultation, percussion, and palpation

Correct answer: D

Rationale: The correct order for abdominal examination is inspection, auscult

4. What is the most critical physiologic change required of newborns at birth?

• A. Transition from fetal to neonatal breathing
• B. Body temperature maintenance
• C. Stabilization of fluid and electrolytes
• D. Closure of fetal shunts in the heart

Correct answer: A

Rationale: The correct answer is A: Transition from fetal to neonatal breathing. The onset of breathing is the most immediate and critical physiologic change required for the transition to extrauterine life. Factors that interfere with this normal transition increase fetal asphyxia, which is a condition of hypoxemia, hypercapnia, and acidosis. While body temperature maintenance, stabilization of fluid and electrolytes, and closure of fetal shunts in the heart are crucial changes in the transition to extrauterine life, breathing and the exchange of oxygen for carbon dioxide must take precedence as they are essential for newborn survival.

5. A 3-year-old child, previously potty-trained, becomes a bed-wetter again during a hospital stay. Which explanation should the nurse provide to the parents?

• A. “Your child is no longer potty-trained and will need to be retrained when she goes home.”
• B. “The child may have developed a bladder infection in the hospital. I will notify the doctor.”
• C. “Preschool children may regress in their behaviors when they are ill in the hospital but should return to normal when they go back home.”
• D. “Don’t worry about it, she is fine.”

Correct answer: C

Rationale: During a hospital stay, preschool children may exhibit regression in behaviors such as bed-wetting due to stress. It is important for parents to understand that this behavior is a common response to the hospital environment and should resolve once the child is back home. Therefore, the correct explanation for the nurse to provide to the parents is choice C. Choice A is incorrect because it inaccurately states that the child is no longer potty-trained. Choice B is incorrect as it assumes a medical issue without evidence. Choice D is incorrect as it dismisses the parents' concerns without addressing the underlying cause of the behavior.

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