Nursing Elites

1. 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.

2. What is the leading cause of morbidity and mortality in children with cystic fibrosis?

• A. Respiratory infections
• B. Malnutrition
• C. Diabetes
• D. Liver disease

Correct answer: A

Rationale: Respiratory infections are the leading cause of morbidity and mortality in children with cystic fibrosis. Cystic fibrosis primarily affects the respiratory system, leading to thick mucus buildup in the lungs, which predisposes these children to recurrent respiratory infections. Malnutrition and diabetes are common comorbidities in cystic fibrosis but are not the leading causes of morbidity and mortality in affected children. Liver disease can occur in cystic fibrosis but is less common than respiratory complications.

3. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?

• A. Surgical therapy is indicated.
• B. Place the infant in a prone position for sleep after feeding.
• C. Thicken feedings and enlarge the nipple hole.
• D. Reduce the frequency of feeding by encouraging larger volumes of formula.

Correct answer: C

Rationale: The correct recommendation for decreasing the number and total volume of emesis in an infant with gastroesophageal reflux is to thicken feedings and enlarge the nipple hole. Thicker feedings can reduce the frequency and volume of emesis by making the food less likely to be regurgitated. Enlarging the nipple hole helps ensure the thickened feedings can pass through. Surgical therapy (Choice A) is not the initial recommendation for managing gastroesophageal reflux in infants. Placing the infant in a prone position for sleep after feeding (Choice B) is not recommended due to the increased risk of sudden infant death syndrome (SIDS). Reducing the frequency of feeding by encouraging larger volumes of formula (Choice D) can exacerbate the reflux symptoms.

4. Prior to giving a hospitalized pre-schooler an injection, the nurse gives the child’s teddy bear a “shot” first. This method is known as:

• A. Critical play
• B. Role play
• C. Diversionary activity
• D. Dramatic play

Correct answer: D

Rationale: The correct answer is D: Dramatic play. Dramatic play involves children acting out experiences to better understand them and reduce fear. In this scenario, by giving the teddy bear a 'shot' first, the nurse is engaging in dramatic play to help the child comprehend and feel more comfortable with the upcoming injection.\n A: Critical play involves critical thinking and problem-solving, not acting out scenarios.\n B: Role play typically involves pretending to be someone else, not necessarily acting out a specific experience.\n C: Diversionary activity aims to distract or redirect attention, which is different from the purpose of dramatic play in this context.

5. After 8 weeks in the neonatal intensive care unit, Chris will soon be discharged. His parents seem apprehensive and worry that he may still be in danger. What is this considered by the nurse?

• A. A common parental reaction
• B. Suggestive of maladaptation
• C. A reason to postpone discharge
• D. Suggestive of inadequate bonding

Correct answer: A

Rationale: Parents become apprehensive and worried as the time for discharge approaches, which is a common parental reaction. They often have concerns and insecurities about caring for their infant. The worry about potential dangers is a normal adaptive response reflecting the parents' concern for their child's well-being. It is essential for healthcare providers to acknowledge these feelings and support parents in gaining confidence in caring for their infant. Choices B, C, and D are incorrect because the parents' apprehension in this context is a typical emotional response and not indicative of maladaptation, a reason to postpone discharge, or inadequate bonding.

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