Nursing Elites

1. What problem is most often associated with myelomeningocele?

• A. Biliary atresia
• B. Hydrocephalus
• C. Craniostenosis
• D. Tracheoesophageal fistula

Correct answer: B

Rationale: Hydrocephalus is the most commonly associated problem with myelomeningocele, present in 80% to 90% of affected children. Biliary atresia and tracheoesophageal fistula are not typically associated with myelomeningocele. Craniostenosis refers to the premature closing of cranial sutures and is not a common issue seen with myelomeningocele.

2. The nurse is planning an educational session for a group of 9-year-olds and their parents aimed at decreasing injuries and accidents among this age group. Which topics should be included in the educational session to accomplish the goal?

• A. Safety rules when dealing with fire to prevent burns.
• B. Safety rules when dealing with toxic substances to prevent poisonings.
• C. Pedestrian, motor vehicle, and bike safety rules.
• D. Safety information regarding the use of all-terrain vehicles (ATVs).

Correct answer: C

Rationale: For school-aged children, pedestrian, motor vehicle, and bike safety are critical areas to focus on as accidents involving these are common in this age group. Education about fire safety and toxic substances is also important, but the priority is on preventing accidents in everyday activities. Therefore, choices A, B, and D are not the most relevant for addressing the goal of decreasing injuries and accidents in this age group.

3. The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?

• A. I should let my infant cry for at least 30 minutes before I respond.
• B. I will swaddle my infant tightly with a soft blanket.
• C. I should massage my infant's abdomen whenever possible.
• D. I will place my infant in an upright seat after feeding.

Correct answer: A

Rationale: Letting an infant cry for prolonged periods can exacerbate colic and increase the infant's distress. It is better to respond promptly to soothe the baby. Other methods like swaddling, gentle massage, and keeping the infant upright can help relieve colic symptoms.

4. An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation?

• A. Water excess
• B. Sodium excess
• C. Water depletion
• D. Potassium excess

Correct answer: C

Rationale: These symptoms are indicative of dehydration or water depletion, which is common in infants and can rapidly lead to severe consequences if not addressed promptly.

5. The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?

• A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
• B. Hold the infant in the prone position after a feeding.
• C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
• D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.

Correct answer: D

Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.

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