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. Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

• A. Avoid asking the child to make choices.
• B. Plan for a teaching session to last about 20 minutes.
• C. Demonstrate on a doll how the procedure will be done.
• D. Show the necessary equipment without allowing child to handle it.

Correct answer: C

Rationale: Demonstrating on a doll helps the toddler understand what will happen in a non-threatening way, making the procedure less intimidating. Long teaching sessions or avoiding choices can increase anxiety.

3. At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?

• A. 4 oz/day
• B. 6 oz/day
• C. 8 oz/day
• D. 12 oz/day

Correct answer: A

Rationale: The American Academy of Pediatrics recommends limiting fruit juice intake to no more than 4 oz per day for infants, as excessive juice can contribute to poor nutrition and dental issues.

4. What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema?

• A. Place an ice pack on the scrotal area.
• B. Place the child in an upright sitting position.
• C. Elevate the scrotum with a rolled washcloth.
• D. Place a warm moist pack to the scrotal area.

Correct answer: C

Rationale: Elevating the scrotum with a rolled washcloth helps reduce edema by promoting fluid drainage. Ice packs are not recommended due to the risk of frostbite, and warm moist packs are not typically used for this purpose. An upright position does not specifically address the edema.

5. At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?

• A. Developmentally appropriate toys
• B. Nutritious snacks served to the children
• C. Handwashing by providers after diaper changes
• D. Certified caregivers for each of the age groups at the facility

Correct answer: C

Rationale: Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.

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