Nursing Elites

1. What dietary modification is recommended for a child with cystic fibrosis?

• A. High carbohydrate
• B. Low protein
• C. High calorie
• D. Low fat

Correct answer: C

Rationale: A high-calorie diet is recommended for children with cystic fibrosis due to their increased energy needs and malabsorption issues. Cystic fibrosis affects the pancreas, leading to poor digestion and absorption of nutrients, particularly fats, which requires dietary adjustments to maintain adequate nutrition. High carbohydrate (Choice A) is not the primary focus; the emphasis is on overall calorie intake. Low protein (Choice B) is not recommended as protein intake is essential for growth and development. Low fat (Choice D) is not the best option as fat-soluble vitamin absorption is already compromised in cystic fibrosis, hence fat restriction is not a priority.

2. The parent of a 2-week-old infant asks the nurse if fluoride supplements are necessary because the infant is exclusively breastfed. What is the nurse's best response?

• A. The infant needs to begin taking them now.
• B. Supplements are not needed if you drink fluoridated water.
• C. The infant may need to begin taking them at age 6 months.
• D. The infant can have infant cereal mixed with fluoridated water instead of supplements.

Correct answer: C

Rationale: Breastfed infants may need fluoride supplements starting at 6 months if they are not receiving fluoride from other sources, such as drinking water.

3. A newborn has been diagnosed with Hirschsprung’s disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?

• A. Acute diarrhea and dehydration
• B. Current jelly-like stools and pain
• C. Failure to pass meconium and abdominal distension
• D. Projectile vomiting and altered electrolytes

Correct answer: C

Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung’s disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung’s disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.

4. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

• A. At the lacrimal duct
• B. On the sclera while the child looks to the outside
• C. In the conjunctival sac when the lower eyelid is pulled down
• D. Carefully under the eyelid while it is gently pulled upward

Correct answer: C

Rationale: Eye drops should be placed in the conjunctival sac, which allows the medication to be absorbed properly without causing irritation. Placing drops directly on the sclera or near the lacrimal duct is less effective and can cause discomfort.

5. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

• A. Dilating the stoma
• B. Assessing bowel function
• C. Limitation of physical activities
• D. Measures to prevent prolapse of the rectum

Correct answer: B

Rationale: Postoperative teaching should focus on assessing bowel function to ensure the colostomy is functioning properly. This includes monitoring stool output, color, consistency, and signs of infection or blockage. Choice A, dilating the stoma, is not recommended without healthcare provider guidance, as it can lead to complications. Choice C, limitation of physical activities, may not be as crucial immediately after colostomy creation. Choice D, measures to prevent prolapse of the rectum, is more relevant for conditions like rectal prolapse and not specifically for a colostomy.

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