Nursing Elites

1. Why are neonates predisposed to problems with thermoregulation?

• A. Renal function is not fully developed
• B. Flexed posture favors heat loss
• C. A large body surface area favors heat loss to the environment
• D. A thick layer of subcutaneous fat provides excellent insulation

Correct answer: C

Rationale: Newborns have a large surface area relative to their body weight, making them more susceptible to heat loss and requiring careful thermoregulation. Choice A is incorrect because renal function is not directly related to thermoregulation. Choice B is incorrect because a flexed posture actually helps reduce heat loss by minimizing the surface area exposed to the environment. Choice D is incorrect because neonates have limited subcutaneous fat, which contributes to their susceptibility to heat loss.

2. What is the most appropriate action for a child with epistaxis?

• A. Have the child lie flat
• B. Pinch the nose and lean forward
• C. Apply a warm compress to the nose
• D. Encourage deep breathing

Correct answer: B

Rationale: The most appropriate action for a child with epistaxis is to pinch the nose and lean forward. This technique helps stop the bleeding and prevent aspiration of blood. By applying pressure to the bleeding vessels and allowing the blood to drain out of the nostrils instead of being swallowed, the risk of nausea and airway obstruction is reduced. Having the child lie flat (Choice A) may lead to blood flowing down the throat, causing potential choking. Applying a warm compress (Choice C) is not typically recommended for epistaxis as cold compresses are more effective. Encouraging deep breathing (Choice D) is not directly related to managing epistaxis.

3. The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease about foods that can exacerbate acid reflux. What foods should be included in the teaching session?

• A. Citrus
• B. All of the above
• C. Spicy foods
• D. Peppermint

Correct answer: B

Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.

4. What does the American Academy of Pediatrics recommend as the best form of infant nutrition?

• A. Exclusive breastfeeding until 1 year of age
• B. Exclusive breastfeeding until 6 months of age
• C. Commercially prepared infant formula until 1 year of age
• D. Commercially prepared infant formula until 4 to 6 months of age

Correct answer: A

Rationale: The American Academy of Pediatrics advocates for exclusive breastfeeding until 1 year of age as the best form of infant nutrition. Breastfeeding for the first year of life provides optimal nutrition and benefits for the infant. Exclusive breastfeeding until 6 months of age is not in line with the AAP's recommendation for a full year. While commercially prepared infant formula is an alternative if breastfeeding is not possible, it is not the preferred choice according to AAP guidelines. The recommendation for commercial infant formula until 1 year of age is not in line with the AAP's stance on the benefits of extended breastfeeding.

5. The nurse is preparing to feed a 10-month-old child diagnosed with failure to thrive (FTT). Which actions should the nurse plan to implement?

• A. Be persistent.
• B. Introduce new foods slowly.
• C. All are correct
• D. Maintain a calm, even temperament.

Correct answer: C

Rationale: Persistence in feeding, introducing new foods slowly, and maintaining a calm temperament are key strategies in managing FTT. A stimulating atmosphere may overwhelm the child and should be minimized during feeding times.

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