Nursing Elites

1. What does the Hib conjugate vaccine protect against?

• A. Bacterial meningitis
• B. Epiglottitis
• C. Bacterial pneumonia
• D. All Correct

Correct answer: D

Rationale: The Hib conjugate vaccine is crucial for protecting children from several severe infections caused by Haemophilus influenzae type b, including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. Therefore, all the provided options are correct. Bacterial meningitis, epiglottitis, and bacterial pneumonia are serious conditions that the Hib vaccine effectively prevents, making choice D the correct answer. Choices A, B, and C are incorrect when considered individually as the Hib vaccine does not protect against only one specific infection; rather, it provides immunity against multiple diseases caused by Haemophilus influenzae type b.

2. What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

• A. Infarction of renal vessels
• B. Immune complex formation and glomerular deposition
• C. Bacterial endotoxin deposition on and destruction of glomeruli
• D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation

Correct answer: B

Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.

3. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?

• A. Wean the infant from TPN gradually
• B. Stimulate adaptation of the small intestine
• C. Provide additional nutrients that cannot be included in the TPN
• D. Offer parents encouragement that the child is close to discharge

Correct answer: B

Rationale: Continuous enteral feedings help stimulate the small intestine's adaptation in short bowel syndrome, promoting better nutrient absorption and eventually reducing reliance on TPN. This approach is crucial for long-term management and improving the child's prognosis. Choice A is incorrect because weaning off TPN typically occurs gradually over time, not the next day. Choice C is incorrect because TPN can be adjusted to provide necessary nutrients, and enteral feedings are mainly used to stimulate intestinal function. Choice D is incorrect as the addition of enteral feedings does not necessarily indicate imminent discharge; it primarily focuses on enhancing intestinal adaptation and reducing reliance on TPN.

4. The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby’s formula faster. What should the nurse recommend?

• A. Heat only 8 oz or more.
• B. Do not heat a plastic bottle in a microwave oven.
• C. Leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Heating formula in a plastic bottle in the microwave can cause uneven heating and release harmful chemicals from the plastic.

5. How is masturbation in the pre-school child viewed?

• A. Abnormal behavior that needs to be dealt with immediately
• B. Disruptive to the family
• C. Normal behavior that can best be dealt with by ignoring and providing distraction
• D. Embarrassing to the parents

Correct answer: C

Rationale: Masturbation in preschool children is a normal behavior as they explore their bodies. It is best viewed as a natural part of development. Parents are often advised to ignore it and provide distractions rather than making the child feel ashamed or embarrassed. Choice A is incorrect because it is a natural behavior and not considered abnormal in this context. Choice B is incorrect as it does not necessarily disrupt the family. Choice D is incorrect as the focus should be on the child's development and well-being, not on the parents' feelings of embarrassment.

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