Nursing Elites

1. What is the primary consideration of susceptibility to infections in neonates?

• A. Increased humoral immunity
• B. Overwhelming anti-inflammatory response
• C. Diminished nonspecific and specific immunity
• D. Excessive levels of immunoglobulin A and immunoglobulin M

Correct answer: C

Rationale: The primary consideration of susceptibility to infections in neonates is their diminished nonspecific and specific immunity. Neonates lack the ability to mount a robust immune response, making them vulnerable to infections. Choice A is incorrect because neonates do not have increased humoral immunity; rather, their humoral immunity is diminished. Choice B is incorrect as neonates do not have an overwhelming anti-inflammatory response; instead, their immune responses are generally weakened. Choice D is incorrect because neonates have diminished or absent levels of immunoglobulin A and immunoglobulin M, contributing to their susceptibility to infections.

2. If the needs of the infant are met in a loving, consistent manner, the infant will develop a sense of:

• A. Trust
• B. Love
• C. Independence
• D. Responsibility

Correct answer: A

Rationale: The correct answer is A: Trust. According to Erikson's psychosocial development theory, when infants receive consistent and loving care, they develop trust. This trust forms the basis of the first stage of psychosocial development, known as Trust vs. Mistrust. Trust is essential for healthy social and emotional development. Choice B, Love, is incorrect as it is more of an emotion than a developmental stage. Choice C, Independence, typically occurs later in development during Erikson's Autonomy vs. Shame and Doubt stage. Choice D, Responsibility, is also not the correct answer as it relates more to later stages of development where individuals develop a sense of duty and obligation.

3. What is a common significant side effect of opioid administration?

• A. Euphoria
• B. Diuresis
• C. Constipation
• D. Allergic reactions

Correct answer: C

Rationale: Constipation is one of the most common side effects of opioid administration due to the slowing down of gastrointestinal motility. Opioids affect the bowel movements, leading to constipation. Euphoria, while a possible effect, is less common than constipation. Diuresis is not a typical side effect of opioids; instead, urinary retention may occur. Allergic reactions are rare side effects of opioids, with symptoms such as rash, itching, or anaphylaxis.

4. 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.

5. The nurse is assessing a 3-year-old African American child whose height and weight are at the 20th percentile on the growth chart. What should the nurse recognize?

• A. The data suggest the child requires nutritional intervention
• B. The NCHS charts are accurate for U.S. African American children
• C. A correction factor is used for nonwhite ethnic groups
• D. No assessment can be made until several measurements are plotted over time

Correct answer: B

Rationale: The NCHS growth charts serve as reference guides for all racial or ethnic groups, including African American children. The 20th percentile for height and weight does not indicate nutritional failure but provides a reference point for ongoing assessment. Choice A is incorrect because being at the 20th percentile does not automatically imply the need for nutritional intervention. Choice C is incorrect as there is no correction factor specifically used for nonwhite ethnic groups in this context. Choice D is incorrect as a single measurement at the 20th percentile can provide valuable information for assessment.

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