Nursing Elites

1. A 14-month-old had cleft palate surgical repair several days ago. The parents ask the nurse about feedings after discharge. Which lunch is the best example of an appropriate meal?

• A. Hot dog, carrot sticks, gelatin, milk
• B. Soup, blenderized soft foods, ice cream, milk
• C. Peanut butter and jelly sandwich, chips, pudding, milk
• D. Baked chicken, applesauce, cookie, milk

Correct answer: B

Rationale: Choice B, 'Soup, blenderized soft foods, ice cream, milk,' is the correct answer. After cleft palate repair, it is essential to provide soft and blenderized foods to prevent trauma to the surgical site and promote proper healing. Choices A, C, and D contain foods that may be difficult for the child to consume comfortably and safely after a cleft palate surgical repair. A hot dog, carrot sticks, chips, and hard cookies could potentially cause injury or discomfort to the surgical area. Peanut butter and jelly sandwich might be too difficult to swallow or may stick to the surgical site. Baked chicken could be too challenging to chew. Therefore, the best choice for an appropriate meal post cleft palate repair is soft, blenderized foods like soup, along with other soft options like ice cream and milk.

2. When asked to help develop interventions to combat obesity among children, the community health nurse should stress the importance of implementing which activity?

• A. Set goals that are focused on developing healthier lifestyles.
• B. Develop strict diet plans for school-aged children.
• C. Provide diet classes for obese children during school hours.
• D. Require all children to participate in organized team sports.

Correct answer: A

Rationale: The correct answer is A: Setting goals that are focused on developing healthier lifestyles. This approach is essential in combating childhood obesity as it promotes sustainable habits and behaviors. Option B, developing strict diet plans, may not be effective in the long term and could lead to unhealthy relationships with food. Option C, providing diet classes during school hours, may not address the root causes of obesity and could potentially stigmatize the children. Option D, requiring all children to participate in organized team sports, may not be feasible for all children and might not address dietary habits and sedentary behaviors.

3. A child is diagnosed with poison ivy. The mother tells the nurse that she does not know how her child contracted the rash since he had not been playing in wooded areas. As the nurse asks questions about possible contact, which of the following would the nurse recognize as highest risk for exposure?

• A. Playing with toys in a backyard flower garden
• B. Eating small amounts of grass while playing 'farm'
• C. Playing with cars on the pavement near burning leaves
• D. Throwing a ball to a neighborhood child who has poison ivy

Correct answer: C

Rationale: The correct answer is C. Poison ivy can be contracted through smoke from burning plants, which can carry the urushiol oil that causes the rash. Playing near burning leaves would be the highest risk for exposure in this scenario. Choices A, B, and D do not involve direct contact with burning plants or leaves, making them lower-risk activities for exposure to poison ivy.

4. Which client has the highest risk for developing community-acquired pneumonia?

• A. a 40-year-old first-grade teacher who works with underprivileged children
• B. a 75-year-old retired secretary with exercise-induced wheezing
• C. a 60-year-old homeless person who is an alcoholic and smokes
• D. a 35-year-old aerobics instructor who skips meals and eats only vegetables

Correct answer: C

Rationale: The correct answer is C because homeless individuals who are alcoholics and smoke have a higher risk of developing community-acquired pneumonia due to factors like poor living conditions, compromised immune systems, and increased exposure to infections. Choice A is less likely as the teacher's profession, while involving contact with children, may not pose as high a risk as the factors in choice C. Choice B may have respiratory issues but does not have the same risk factors as choice C. Choice D, the aerobics instructor, may have a healthy lifestyle but skipping meals and a restrictive diet do not directly correlate with a higher risk of pneumonia compared to the risk factors in choice C.

5. A 6-month-old infant who is being treated for developmental dysplasia of the hip has been placed in a hip spica cast. The nurse should teach the parents to

• A. Gently rub the skin with a cotton swab to relieve itching
• B. Place the favorite books and push-pull toys in the crib
• C. Check every few hours for the next day or 2 for swelling in the baby's feet
• D. Turn the baby with the abduction stabilizer bar every 2 hours

Correct answer: C

Rationale: The correct answer is to check every few hours for the next day or 2 for swelling in the baby's feet. Swelling in the baby's feet could indicate compromised circulation due to the cast, and frequent checks are necessary to ensure that there are no complications. Choices A, B, and D are incorrect because rubbing the skin with a cotton swab, placing favorite items in the crib, and turning the baby with the abduction stabilizer bar do not address the potential issue of compromised circulation and swelling in the baby's feet.

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