Nursing Elites

1. Which parental statement indicates correct understanding of information presented regarding the prevention of iron deficiency anemia in infants?

• A. "We will add green leafy vegetables to our child’s low-iron formula."
• B. "We will discontinue the use of vitamin C supplements by 6 months of age."
• C. "We will begin an iron-fortified infant cereal at 4 to 6 months of age."
• D. "We will introduce cow’s milk by 6 months of age."

Correct answer: C

Rationale: The correct answer is C. Introducing iron-fortified cereal between 4 to 6 months of age is a recommended practice to prevent iron deficiency anemia in infants. Iron-fortified infant cereals are a good source of iron for infants. Choices A and B are incorrect because adding green leafy vegetables to low-iron formula and discontinuing vitamin C supplements do not directly address the prevention of iron deficiency anemia. Choice D is incorrect because cow's milk should be avoided before 12 months of age as it is low in iron and can lead to intestinal blood loss, increasing the risk of iron deficiency anemia.

2. For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?

• A. Appetite increases and blood pressure is normal
• B. Urinary tract infection is gone and edema subsides
• C. Generalized edema subsides and blood pressure is normal
• D. Diuresis occurs as urinary protein excretion diminishes

Correct answer: D

Rationale: The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.

3. The nurse is interviewing the father of a 10-month-old girl. The child is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says no firmly and moves her away from the outlet. The nurse should use this opportunity to teach the father what?

• A. That the child should be given a time-out
• B. That the child is old enough to understand the word no
• C. That the child will learn safety issues better if she is spanked
• D. That the child should already know that electrical outlets are dangerous

Correct answer: B

Rationale: At 10 months, children are beginning to understand simple commands like "no." It is important for parents to reinforce this understanding consistently to help the child learn about boundaries and safety.

4. A child is refusing to use the potty and having accidents, even though he has achieved toilet training. This is an example of which type of behavior?

• A. Positive reinforcement
• B. Desensitization
• C. Phobia
• D. Regression

Correct answer: D

Rationale: The correct answer is D, regression. Regression occurs when a child reverts to an earlier behavior, such as having accidents after being successfully toilet trained. This regression often happens due to stress or changes in routine. Choices A, B, and C are incorrect because positive reinforcement involves encouraging desired behavior, desensitization is a process of reducing sensitivity to a stimulus, and phobia is an intense fear or aversion to a specific object or situation, none of which directly apply to the described situation of the child having accidents after being toilet trained.

5. The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?

• A. Place the child in the Trendelenburg position.
• B. Apply moist heat to the abdomen.
• C. Allow the child to assume a position of comfort.
• D. Administer a saline enema to cleanse the bowel.

Correct answer: C

Rationale: Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.

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