Nursing Elites

1. What action should be taken by the healthcare provider for a child who has ingested a corrosive product?

• A. Induce vomiting using Ipecac to remove the corrosive agent.
• B. Administer vinegar or lemon juice to neutralize the caustic agent.
• C. Give activated charcoal to decontaminate the stomach.
• D. Telephone the poison control center and follow their advice.

Correct answer: D

Rationale: In cases of corrosive product ingestion, it is crucial to contact the poison control center for guidance. Inducing vomiting or attempting to neutralize the agent can lead to further harm. The poison control center professionals are trained to provide specific instructions tailored to the situation, ensuring the best possible outcome for the child. Therefore, the correct action is to call the poison control center for appropriate advice. Inducing vomiting can cause additional damage by re-exposing the esophagus and mouth to the corrosive substance. Administering vinegar or lemon juice is not recommended as it may worsen the situation by causing a chemical reaction. While activated charcoal can be useful in some cases of poisoning, it is not recommended for corrosive substances as it is ineffective in binding to them.

2. The mother of a one-month-old calls the clinic to report that the back of her infant's head is flat. How should the nurse respond?

• A. Turn the infant on the left side braced against the crib when sleeping.
• B. Prop the infant in a sitting position with a cushion when not sleeping.
• C. Place a small pillow under the infant's head while lying on the back.
• D. Position the infant on the stomach occasionally when awake and active.

Correct answer: D

Rationale: Positioning the infant on the stomach occasionally when awake and active can help prevent flat spots on the head. This position allows for more natural movement and prevents prolonged pressure on one area of the head, reducing the risk of developing a flat spot. Turning the infant on the left side braced against the crib when sleeping (choice A) is not recommended as it does not address the issue of flat spots. Propping the infant in a sitting position with a cushion when not sleeping (choice B) may increase the risk of falls and is not suitable for a one-month-old. Placing a small pillow under the infant's head while lying on the back (choice C) should be avoided due to the risk of suffocation and sudden infant death syndrome (SIDS).

3. The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?

• A. The aortic semilunar valve obstructs blood flow into the systemic circulation
• B. The lumen of the aorta reduces the volume of the blood flow to the lower extremities
• C. The pulmonic valve prevents adequate blood volume into the pulmonary circulation
• D. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt

Correct answer: B

Rationale: The findings are consistent with coarctation of the aorta, where narrowing of the aorta leads to decreased blood flow to the lower extremities. This results in higher blood pressure in the arms compared to the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Choices A, C, and D are incorrect because they do not align with the pathophysiological mechanisms of coarctation of the aorta, which specifically involves narrowing of the aortic lumen reducing blood flow to the lower extremities.

4. An adolescent’s mother calls the primary HCP’s office to inquire about the results of her daughter’s serum test that was drawn last week. Since it is the teenager’s 18th birthday, how should the nurse respond to this mother’s inquiry?

• A. Ask when the adolescent was last seen in the clinic
• B. Tell the mother to have the teenager call the clinic
• C. Since the serum sample was drawn last week, provide the mother with the findings
• D. Explain that the information cannot be released without the 18-year-old's permission

Correct answer: D

Rationale: When an individual turns 18, they are considered a legal adult and have the right to privacy regarding their medical information. Therefore, the nurse should explain to the mother that without the 18-year-old's permission, the results cannot be disclosed.

5. When developing a behavior modification program for an extremely aggressive 10-year-old boy, what should the nurse do first?

• A. Identify what activities, foods, and toys the child enjoys
• B. Assess the child's previous reactions to punishment
• C. Offer the child positive feedback
• D. Involve other children on the unit in describing the token system

Correct answer: A

Rationale: The first step in developing a behavior modification program for an extremely aggressive 10-year-old boy is to identify what activities, foods, and toys the child enjoys. Understanding the child's motivations is crucial in creating an effective behavior modification plan tailored to his interests and preferences, which can help in positively reinforcing desired behaviors.

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