Nursing Elites

1. A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs?

• A. The infant's IV line has infiltrated.
• B. The infant has not voided since surgery.
• C. The infant's mother states the infant is tolerating the feeding okay.
• D. The infant is taking the Pedialyte without vomiting or distention.

Correct answer: D

Rationale: The decision to advance feedings after a pyloromyotomy is based on the infant's ability to tolerate the current feedings without vomiting or abdominal distention. Ensuring the infant can keep down Pedialyte is the key indicator for moving to the next stage of feeding. Choices A, B, and C are incorrect because they do not directly relate to the infant's ability to tolerate the feeding. An infiltrated IV line, lack of voiding, or the mother's statement do not provide direct information on the infant's tolerance to the feeding, unlike the absence of vomiting and distention.

2. The nurse is caring for a child with Neuroblastoma. Where is the tumor most commonly located?

• A. Bone
• B. Kidneys
• C. Cortex
• D. Abdomen

Correct answer: D

Rationale: Neuroblastoma is a cancer that commonly originates in the adrenal glands located in the abdomen. It can also occur in nerve tissues along the spine, but it is most frequently found in the abdominal region. Therefore, the correct answer is D. Choices A, B, and C are incorrect as Neuroblastoma typically arises from neural crest cells in the adrenal glands or sympathetic ganglia, not in the bones, kidneys, or cortex.

3. What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

• A. White rice
• B. Popcorn
• C. Fruit juice
• D. Ripe bananas

Correct answer: B

Rationale: Popcorn is a high-fiber food that can help manage chronic constipation in children. Other options like white rice and ripe bananas are low in fiber and less effective for treating constipation.

4. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

• A. Isotonic dehydration
• B. Hypotonic dehydration
• C. Hypertonic dehydration
• D. Hyperosmotic dehydration

Correct answer: B

Rationale: Hypotonic dehydration occurs when the loss of electrolytes exceeds the loss of water, leading to a decrease in plasma osmolarity. This often occurs when sodium loss is greater than water loss, as in diarrhea or vomiting.

5. A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care?

• A. Use an 18-gauge needle if possible.
• B. Show the child the equipment to be used before the procedure.
• C. If not successful after four attempts, have another nurse try.
• D. Restrain the child completely.

Correct answer: B

Rationale: Showing the child the equipment before the procedure helps build trust and reduces fear. Using an 18-gauge needle is too large for a child, and multiple attempts can increase trauma. Restraining completely can increase fear and anxiety.

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