Nursing Elites

1. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?

• A. The parent is trying to feed the child only what the child likes most
• B. Hispanics believe the evil eye enters when a person gets cold
• C. The parent is trying to restore normal balance through appropriate hot remedies
• D. Hispanics believe an innate energy called chi is strengthened by eating soup

Correct answer: C

Rationale: In Hispanic culture, the balance between hot and cold is important, and the parent may be giving the child broth to restore this balance while avoiding "cold" foods.

2. A child is admitted with suspected pyloric stenosis. Which of the following should be included in the plan of care?

• A. Monitor for signs of metabolic acidosis
• B. Observe for projectile vomiting
• C. Provide large, infrequent feedings to allow for rest
• D. Place the infant in a supine position after feeding

Correct answer: B

Rationale: The correct answer is B: 'Observe for projectile vomiting.' Projectile vomiting is a classic sign of pyloric stenosis, caused by obstruction at the pylorus. Choice A is incorrect as metabolic alkalosis, not acidosis, often occurs due to the loss of hydrochloric acid from persistent vomiting. Choice C is incorrect as frequent, small feedings are preferred to prevent overloading the stomach. Choice D is incorrect as placing the infant in an upright position after feeding can help reduce reflux.

3. What is the appropriate method for measuring the temperature of a 2-day-old neonate?

• A. Tympanic
• B. Oral
• C. Axillary
• D. Rectal

Correct answer: C

Rationale: For a 2-day-old neonate, the most suitable method to measure temperature is the axillary method. This approach is considered safe and appropriate for neonates, minimizing the risk of injury. Tympanic temperature measurement may not be as accurate in neonates due to their small ear canals. Oral temperature measurement is not recommended for neonates as they may not be able to hold a thermometer properly in their mouths. Rectal temperature measurement is invasive and carries a higher risk of injury and should be avoided unless absolutely necessary.

4. A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed? (Select all that apply.)

• A. Dialysis
• B. All below
• C. Sodium bicarbonate
• D. Glucose 50% and insulin

Correct answer: A

Rationale: Calcium gluconate, sodium bicarbonate, and glucose with insulin are used as temporary measures to rapidly reduce serum potassium levels. They help shift potassium into cells and stabilize the heart but do not remove potassium from the body like dialysis does.

5. What is the number one leading cause of death in children over 1 year of age?

• A. Congenital anomalies
• B. Homicide
• C. Suicide
• D. Accidents

Correct answer: D

Rationale: Accidents, such as motor vehicle accidents, drowning, and falls, are the primary cause of death in children over 1 year of age. While congenital anomalies can be a significant cause of mortality in infants, they are less common in older children. Homicide and suicide are serious issues but are not as prevalent as accidents in causing death among children over 1 year of age.

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