Nursing Elites

1. What intervention best meets a major developmental need of a newborn in the immediate postoperative period?

• A. Giving a pacifier to the newborn
• B. Placing a mobile over the newborn's crib
• C. Providing the newborn with a soft, cuddly toy
• D. Warming the newborn's formula before feeding

Correct answer: A

Rationale: The correct answer is giving a pacifier to the newborn. Sucking is a natural reflex and a source of comfort for newborns, especially postoperatively. Offering a pacifier can help meet their developmental needs by providing comfort and a soothing mechanism. Placing a mobile over the crib (choice B) may provide visual stimulation but does not directly address the newborn's developmental needs for comfort and self-soothing. Providing a soft, cuddly toy (choice C) may offer some comfort but may not be as effective in meeting the specific developmental need for sucking postoperatively. Warming the newborn's formula before feeding (choice D) relates more to feeding practices than directly addressing a major developmental need in the postoperative period.

2. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department, and her arm placed in a cast. At 11 p.m., her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?

• A. Notifying the doctor immediately
• B. Applying ice
• C. Elevating the arm
• D. Giving additional pain medication as ordered

Correct answer: A

Rationale: The correct action would be to notify the doctor immediately. Unrelenting pain despite medication can indicate compartment syndrome, which is a medical emergency requiring immediate attention. Applying ice or elevating the arm may not address the potential serious underlying issue of compartment syndrome. Giving additional pain medication without further assessment could delay necessary intervention and potentially worsen the condition.

3. What factor predisposes the urinary tract to infection in children?

• A. increased fluid intake
• B. short urethra in young girls
• C. prostatic secretions in males
• D. frequent emptying of the bladder

Correct answer: B

Rationale: The short urethra in young girls is a significant factor that predisposes them to urinary tract infections. Girls have a shorter urethra than boys, making it easier for bacteria to travel up the urinary tract, leading to infections. Increased fluid intake (Choice A) is actually a preventive measure as it helps flush out bacteria from the urinary tract. Prostatic secretions in males (Choice C) do not predispose the urinary tract to infection in children. Frequent emptying of the bladder (Choice D) is also a good practice to prevent urinary tract infections by reducing the chances of bacterial growth in the urinary tract.

4. A 6-year-old with muscular dystrophy was recently injured falling out of bed at home. What intervention should the nurse suggest to prevent further injury?

• A. Recommend raising the bed's side rails when a caregiver is not present.
• B. Suggest a caregiver be present continuously to prevent falls from bed.
• C. Encourage the use of loose restraints while in bed.
• D. Recommend raising the bed's side rails throughout the day and night.

Correct answer: A

Rationale: In this scenario, the most appropriate intervention to prevent further injury is to raise the bed's side rails when a caregiver is not present. This measure helps in preventing falls without the need for constant supervision. Choice B is not practical as continuous caregiver presence may not always be feasible. Choice C is unsafe as loose restraints can pose a strangulation risk. Choice D does not address the need for intervention when a caregiver is absent, potentially leading to an increased risk of falls.

5. A 3-year-old child is being discharged after being treated for dehydration. What should be included in the discharge teaching?

• A. Monitor for signs of infection
• B. Monitor for signs of dehydration
• C. Monitor for signs of hypovolemia
• D. Monitor for signs of malnutrition

Correct answer: B

Rationale: The correct answer is to monitor for signs of dehydration. After treatment for dehydration, it is crucial to educate caregivers about recognizing early signs of dehydration to prevent its recurrence. Monitoring for dehydration ensures that appropriate measures can be taken promptly if signs reappear. Choices A, C, and D are incorrect because infection, hypovolemia, and malnutrition, while important considerations in healthcare, are not the primary focus after treating dehydration in a 3-year-old child.

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