Nursing Elites

1. Why might a healthcare provider question a health care provider's order for a tap water enema for a 6-month-old infant with suspected Hirschsprung disease?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas are unlikely to lead to loss of necessary nutrients. Choice C is incorrect as it does not directly relate to the physiological risk of tap water enemas. Choice D is incorrect as shock from a sudden drop in temperature is not a common concern with tap water enemas.

2. What behavior does the nurse anticipate when feeding a newborn with choanal atresia?

• A. Chokes during feeding
• B. Experiences swallowing challenges
• C. Lacks hunger cues
• D. Takes about half of the feeding

Correct answer: D

Rationale: When feeding a newborn with choanal atresia, the nurse can anticipate that the infant may take only part of the feeding before pausing for air. This is due to the fact that infants with choanal atresia struggle to breathe through their nose while feeding. Choice A is incorrect as choking typically involves a more severe airway obstruction. Choice B is incorrect because difficulty swallowing is not the primary concern in choanal atresia. Choice C is incorrect as the issue is not related to hunger cues but rather the physiological challenges associated with breathing while feeding.

3. The nurse closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?

• A. infection
• B. hypertension
• C. encephalopathy
• D. edema

Correct answer: A

Rationale: Monitoring the temperature of a child with minimal change nephrotic syndrome is crucial to detect early signs of infection. Infection is a common complication in nephrotic syndrome, and fever can be an early indicator. Hypertension (choice B) is not typically associated with nephrotic syndrome. Encephalopathy (choice C) is a neurological complication and would present with altered mental status rather than a change in temperature. Edema (choice D) is a common symptom of nephrotic syndrome but is not typically monitored through temperature assessment.

4. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential in managing type 1 diabetes mellitus as it helps in monitoring blood sugar levels at different times of the day and adjusting insulin doses accordingly. Option B about using a lancet device to obtain blood samples is a technique rather than an emphasis on monitoring frequency. Option C suggesting the use of urine test strips is incorrect as urine test strips are not recommended for accurate real-time monitoring of blood glucose levels in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when educating about blood glucose monitoring.

5. Before starting kindergarten, the child should receive boosters of which primary immunizations to ensure ongoing protection?

• A. IPV, HepB, Td.
• B. DTaP, HepB, Td.
• C. MMR, DTaP, Hib.
• D. DTaP, IPV, MMR.

Correct answer: D

Rationale: Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR. DTaP provides protection against diphtheria, tetanus, and pertussis, IPV protects against polio, and MMR immunization covers measles, mumps, and rubella. These boosters are essential to maintain immunity and protect the child from these diseases as they enter school. Choices A, B, and C are incorrect because they do not include the recommended boosters for kindergarten entry and may leave the child susceptible to certain infections.

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