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. In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?

• A. Deficient fluid volume related to dehydration
• B. Excess fluid volume related to edema
• C. Deficient knowledge related to fluid intake regimen
• D. Imbalanced nutrition, more than body requirements related to excess weight

Correct answer: A

Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.

3. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?

• A. Monitor for signs of infection
• B. Monitor blood pressure
• C. Monitor for hyperglycemia
• D. Monitor for hypertension

Correct answer: A

Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention. While monitoring blood pressure, hyperglycemia, and hypertension are important considerations in certain conditions and treatments, they are not the primary concern when a child with nephrotic syndrome is on corticosteroid therapy.

4. A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the nurse expect?

• A. Proteinuria
• B. Peripheral edema
• C. Elevated hematocrit
• D. Absence of pedal pulses

Correct answer: C

Rationale: In a child with a congenital cardiac malformation causing right-to-left shunting of blood, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not a typical clinical finding related to right-to-left shunting. Peripheral edema (Choice B) is more commonly associated with conditions causing volume overload, such as left-sided heart failure. Absence of pedal pulses (Choice D) is not directly related to right-to-left shunting but may be seen in conditions affecting peripheral circulation.

5. What explanation should the nurse give a parent about the purpose of a tetanus toxoid injection for their child?

• A. Passive immunity is conferred temporarily.
• B. Long-lasting active immunity is conferred.
• C. Lifelong active natural immunity is conferred.
• D. Passive natural immunity is conferred temporarily.

Correct answer: B

Rationale: The correct answer is B: Long-lasting active immunity is conferred. Tetanus toxoid injection works by stimulating the child's body to produce its antibodies, providing long-lasting active immunity. Choice A is incorrect because passive immunity is not conferred for life; it is temporary and involves receiving antibodies rather than producing them internally. Choice C is incorrect as the immunity conferred by the tetanus toxoid injection is not lifelong natural immunity but rather active immunity stimulated by the body's immune response. Choice D is also incorrect since passive natural immunity is not conferred by the tetanus toxoid injection, and it is not temporary.

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