Nursing Elites

1. A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?

• A. Provide crib toys for distraction
• B. Breast- or bottle-feeding can begin immediately
• C. Give pain medication to the infant to minimize crying
• D. Leave the infant in the crib at all times to prevent suture strain

Correct answer: C

Rationale: Pain management is essential postoperatively to reduce crying, which could place strain on the surgical site. Feeding and holding the infant are allowed, but care should be taken to avoid placing pressure on the suture line.

2. A child has a planned hospitalization in a few weeks, and the client and family appear very stressed. Which nursing action will minimize their stress?

• A. Telling the client and family that everything will be fine
• B. Explaining how the child will benefit from the surgery
• C. Telling the client and family that the surgeon is very good
• D. Giving a tour of the hospital unit or surgical area

Correct answer: D

Rationale: The correct nursing action to minimize the stress of the child and family is giving a tour of the hospital unit or surgical area. Familiarizing them with the hospital environment can help reduce their anxiety by allowing them to see where the child will be staying and the surroundings. Choices A, B, and C do not directly address the need to reduce stress by providing a tangible way to alleviate anxiety through exposure to the hospital setting.

3. What should preoperative care of a newborn with an anorectal malformation include?

• A. Frequent suctioning
• B. Gastrointestinal decompression
• C. Feedings with sterile water only
• D. Supine position with head elevated

Correct answer: C

Rationale: Preoperative care for a newborn with an anorectal malformation should include feedings with sterile water only. This approach is important to avoid complications before surgery. Gastrointestinal decompression is necessary to prevent abdominal distention and potential aspiration, making choice B incorrect. Frequent suctioning and placing the newborn in a supine position with the head elevated are not typically part of the preoperative care protocol for an anorectal malformation, thus choices A and D are incorrect.

4. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

• A. Prevent the spread of infection.
• B. Monitor electrolyte balance.
• C. Prevent abdominal distention.
• D. Maintain accurate records of output.

Correct answer: C

Rationale: The primary purpose of an NG tube post-surgery for Hirschsprung disease is to prevent abdominal distention by decompressing the stomach and intestines. This helps prevent complications and promotes healing.

5. The nurse is preparing a presentation on compensated, decompensated, and irreversible shock in children. What clinical manifestations related to decompensated shock should the nurse include? (Select all that apply.)

• A. All below
• B. Oliguria
• C. Confusion
• D. Pale extremities

Correct answer: A

Rationale: Decompensated shock is characterized by signs such as oliguria, confusion, pale extremities, hypotension, and a thready pulse. These indicate that the body is no longer able to maintain adequate circulation to vital organs.

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