Nursing Elites

1. A child with a diagnosis of cystic fibrosis is admitted to the hospital. What is the priority nursing intervention?

• A. Administering pancreatic enzymes
• B. Providing respiratory therapy
• C. Providing nutritional support
• D. Encouraging physical activity

Correct answer: A

Rationale: The correct answer is administering pancreatic enzymes. In cystic fibrosis, the pancreas is often affected, leading to insufficient production of digestive enzymes. Administering pancreatic enzymes is crucial to ensure proper digestion and absorption of nutrients. While respiratory therapy, nutritional support, and physical activity are essential components of care for individuals with cystic fibrosis, addressing the digestive aspect by administering pancreatic enzymes takes priority to prevent malnutrition and promote overall health.

2. During an oral cavity assessment of a 6-month-old infant, the parent inquires about which teeth will erupt first. How should the healthcare provider respond?

• A. Incisors
• B. Canines
• C. Upper molars
• D. Lower molars

Correct answer: A

Rationale: Incisors are the teeth that typically erupt first in infants, usually around 6 months of age. These teeth play a crucial role in biting and cutting food. Canines, upper molars, and lower molars are not the primary teeth to erupt in infants. Canines usually erupt after incisors, while molars, whether upper or lower, come in later during the teething process.

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 4-year-old child is brought to the emergency department with a suspected fracture. What is the priority nursing action?

• A. Immobilize the affected limb
• B. Apply ice to the affected area
• C. Elevate the affected limb
• D. Check the child's neurovascular status

Correct answer: A

Rationale: The priority nursing action when a child with a suspected fracture is brought to the emergency department is to immobilize the affected limb. Immobilization helps prevent further injury until a fracture is confirmed or ruled out. Applying ice or elevating the limb can wait until after immobilization has been achieved. Checking the child's neurovascular status is important but is not the priority action in this situation.

5. 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: B

Rationale: The correct dietary instruction for a child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye, and it can exacerbate GERD symptoms in some individuals. Avoiding gluten can help reduce inflammation and irritation in the gastrointestinal tract, thereby alleviating symptoms of GERD. Choices A, C, and D are incorrect because while spicy foods, high-fat foods, and dairy products can trigger GERD symptoms in some individuals, avoiding gluten specifically is more relevant for managing GERD.

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