Nursing Elites

1. What explanation should the nurse provide to the parents of a 6-month-old infant diagnosed with cystic fibrosis?

• A. It is a condition affecting the respiratory and digestive systems.
• B. It is an autoimmune disorder affecting multiple organs.
• C. It is a genetic disorder that can be managed with medication.
• D. It is a condition caused by prenatal exposure to toxins.

Correct answer: A

Rationale: The correct answer is A. Cystic fibrosis is a genetic disorder that primarily affects the respiratory and digestive systems. It results in the production of thick, sticky mucus that can clog the lungs and obstruct the pancreas. This explanation is crucial for parents to understand the impact of the condition on their child's health. Choice B is incorrect because cystic fibrosis is not an autoimmune disorder. Choice C is partially correct in that cystic fibrosis is a genetic disorder, but it requires a comprehensive management approach beyond just medication. Choice D is incorrect as cystic fibrosis is not caused by prenatal exposure to toxins but rather by inheriting specific genetic mutations.

2. What is the nurse’s priority intervention when preparing for admission of a child with acute laryngotracheobronchitis?

• A. Pad the side rails of the crib.
• B. Arrange for a quiet, cool room.
• C. Place a tracheotomy set at the bedside.
• D. Obtain a recliner so that a parent can stay.

Correct answer: C

Rationale: The correct answer is to place a tracheotomy set at the bedside. Acute laryngotracheobronchitis can cause airway obstruction, which may require an emergency tracheotomy. Having the tracheotomy set readily available ensures quick access in case of respiratory distress. Padding the side rails of the crib, arranging for a quiet, cool room, and obtaining a recliner for a parent are important aspects of care but are not the priority when managing a potentially life-threatening airway emergency.

3. The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule
• B. Macule
• C. Vesicle
• D. Scale

Correct answer: B

Rationale: A macule is defined as a flat, discolored area on the skin that is different from surrounding tissue due to a change in color. In this case, the baby has a flat, discolored area on the skin, which fits the description of a macule. A papule is a small, raised solid bump, a vesicle is a small fluid-filled blister, and a scale is a flake of skin that is often dry and rough. Therefore, choices A, C, and D do not accurately describe the flat, discolored area on the baby's skin, making them incorrect.

4. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: The correct dietary instruction for a child with GERD is to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux. While avoiding gluten may be necessary for individuals with gluten sensitivity or celiac disease, it is not a standard recommendation for GERD. Avoiding spicy foods and dairy products may help some individuals with GERD, but the most crucial dietary advice is to avoid high-fat foods.

5. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: B

Rationale: The correct dietary instruction for a 2-year-old child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye that can worsen GERD symptoms. Avoiding gluten can help reduce inflammation and discomfort in the esophagus. Choices A, C, and D are incorrect because spicy foods, high-fat foods, and dairy products can exacerbate GERD symptoms. Spicy foods can irritate the esophagus, high-fat foods delay stomach emptying leading to increased acid reflux, and dairy products can stimulate acid production, all of which can worsen GERD symptoms.

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