Nursing Elites

1. A breastfeeding mother reports breast engorgement. The nurse advises her to:

• A. Increase the frequency of feedings
• B. Apply ice packs to the breasts
• C. Avoid breastfeeding until the pain subsides
• D. Use a breast pump to empty the breasts completely

Correct answer: A

Rationale: Breast engorgement occurs when the breasts become overfilled with milk. By increasing the frequency of feedings, the mother can ensure that her breasts are emptied regularly, helping to relieve the discomfort associated with engorgement. This advice promotes effective milk removal and prevents further accumulation, which can worsen the condition. Applying ice packs may provide temporary relief, but it does not address the underlying issue of milk accumulation. Avoiding breastfeeding can lead to further engorgement and potential complications. Using a breast pump to empty the breasts completely may be necessary in some cases, but increasing the frequency of feedings is the initial and most appropriate intervention to manage breast engorgement.

2. A 9-year-old girl was struck by a car while crossing the street. Your assessment reveals a large contusion over the left upper quadrant of her abdomen and signs of shock. Which of the following organs is MOST likely injured?

• A. Liver
• B. Kidney
• C. Pancreas
• D. Spleen

Correct answer: D

Rationale: The presence of a large contusion over the left upper quadrant of the abdomen, along with signs of shock, points towards a likely injury to the spleen, especially following trauma. The spleen is located in the left upper quadrant of the abdomen and is susceptible to injury due to its position and vulnerability to blunt trauma.

3. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

• A. Give the child honey (simple sugar)
• B. Give the child milk (complex sugar)
• C. Contact the healthcare provider before doing anything
• D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

4. In the treatment of an infected hematoma, which of the following is NOT recommended?

• A. Incision and drainage
• B. Systemic antibiotics
• C. A and B
• D. Vitamin E

Correct answer: D

Rationale: Vitamin E is not a standard treatment for infected hematomas. The primary interventions for infected hematomas typically involve incision and drainage to remove infected fluid and debris, along with the administration of systemic antibiotics to combat the infection. Vitamin E does not play a significant role in the treatment of infected hematomas and is therefore not recommended as a primary treatment option. Choice A (Incision and drainage) and Choice B (Systemic antibiotics) are recommended treatments for infected hematomas as they help in removing infected fluid and combating the infection, respectively. Therefore, the correct answer is D, Vitamin E.

5. A 6-year-old male is hospitalized in stable condition with multiple fractures following a car accident. The child's parents tell the nurse that their 7-year-old daughter is very upset about the accident and is concerned that her brother will die. Which suggestion by the nurse is most appropriate?

• A. Encourage the parents to phone the sister frequently with updates on her brother's condition.
• B. Suggest that the sister come to the hospital for a visit.
• C. Suggest that one parent leave the hospital to spend extra time with their daughter at home.
• D. Remind the parents that it is normal for children to be upset when their sibling is hospitalized.

Correct answer: B

Rationale: In situations where a sibling is upset about a family member being hospitalized, suggesting that the sister come to the hospital for a visit can help alleviate her concerns. This allows the sister to see her brother, ask questions, and receive reassurance from seeing him in stable condition. Direct contact and interaction can often provide more comfort and understanding than phone calls or staying at home. Encouraging phone calls (Choice A) might not provide the same level of comfort as a physical visit. While spending extra time with the daughter at home (Choice C) is important, in this scenario, facilitating a visit to the hospital can address the daughter's immediate concerns better. Reminding the parents that it is normal for children to be upset (Choice D) is not as proactive as arranging for the sister to visit her brother.

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