Nursing Elites

1. The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?

• A. Citrus
• B. All of the above
• C. Spicy foods
• D. Peppermint

Correct answer: B

Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.

2. What is the most appropriate nursing action when intermittently gavage feeding a preterm infant?

• A. Allow formula to flow by gravity
• B. Avoid allowing the infant to suck on the tube
• C. Insert the tube through the nares instead of the mouth
• D. Apply gentle pressure to the syringe to deliver the formula

Correct answer: A

Rationale: The correct action when intermittently gavage feeding a preterm infant is to allow the formula to flow by gravity. This method helps prevent overfeeding and aspiration, which can occur if the formula is delivered too quickly under pressure. Choice B is incorrect as sucking on the tube can cause complications. Choice C is incorrect as the tube is typically inserted through the mouth. Choice D is incorrect as steady pressure can lead to rapid delivery of the formula, increasing the risk of complications.

3. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

4. Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests?

• A. Apply a urine collection bag to the perineal area.
• B. Tape a small medicine cup inside of the diaper.
• C. Aspirate urine from cotton balls inside the diaper with a syringe without a needle.
• D. Use a syringe without a needle to aspirate urine from a superabsorbent disposable diaper.

Correct answer: C

Rationale: Aspirating urine from cotton balls inside the diaper is a minimally invasive method and effective for collecting small amounts of urine. Using a collection bag can be more cumbersome, and other methods are not as effective for this age.

5. Evidence-based practice (EBP), a decision-making model, is best described as which?

• A. Using information in textbooks to guide care
• B. Combining knowledge with clinical experience and intuition
• C. Using a professional code of ethics as a means for decision-making
• D. Gathering all evidence that applies to the child’s health and family situation

Correct answer: D

Rationale: Evidence-based practice involves gathering and integrating all relevant evidence to guide clinical decision-making, ensuring that care is based on the best available research.

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