Nursing Elites

1. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, "I want to go back to work, but I don't want Eric to suffer because I'll have less time with him." Which is the nurse's most appropriate answer?

• A. "I'm sure he'll be fine if you get a good babysitter."
• B. "You will need to stay home until Eric starts school."
• C. "Let's talk about the childcare options that will be best for Eric."
• D. "You should go back to work so Eric will get used to being with others."

Correct answer: C

Rationale: The best approach is to discuss childcare options that would suit Eric's needs, allowing the mother to make an informed decision without guilt or pressure.

2. The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)

• A. Encourage fluids.
• B. Monitor urinary output.
• C. Monitor sodium serum levels.
• D. All above

Correct answer: D

Rationale: Gentamicin is an aminoglycoside antibiotic that requires monitoring of serum peak and trough levels to avoid toxicity, particularly nephrotoxicity and ototoxicity. Encouraging fluids and monitoring urinary output are also crucial to minimize the risk of kidney damage.

3. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?

• A. Spitting up
• B. Bilious vomiting
• C. Failure to thrive
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.

4. Which type of play is most appropriate for a hospitalized toddler?

• A. Cooperative play
• B. Parallel play
• C. Competitive play
• D. Solitary play

Correct answer: B

Rationale: The most appropriate type of play for a hospitalized toddler is parallel play. This type of play allows toddlers to engage alongside each other but not directly with each other, which can be comforting and less overwhelming in a hospital setting. Cooperative play (choice A) involves working together towards a common goal, which may be challenging for a hospitalized toddler. Competitive play (choice C) involves a level of rivalry that may not be suitable during a hospital stay. Solitary play (choice D) involves playing alone, which may not provide the social interaction and distraction that parallel play can offer in a hospital environment.

5. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?

• A. Wean the infant from TPN gradually
• B. Stimulate adaptation of the small intestine
• C. Provide additional nutrients that cannot be included in the TPN
• D. Offer parents encouragement that the child is close to discharge

Correct answer: B

Rationale: Continuous enteral feedings help stimulate the small intestine's adaptation in short bowel syndrome, promoting better nutrient absorption and eventually reducing reliance on TPN. This approach is crucial for long-term management and improving the child's prognosis. Choice A is incorrect because weaning off TPN typically occurs gradually over time, not the next day. Choice C is incorrect because TPN can be adjusted to provide necessary nutrients, and enteral feedings are mainly used to stimulate intestinal function. Choice D is incorrect as the addition of enteral feedings does not necessarily indicate imminent discharge; it primarily focuses on enhancing intestinal adaptation and reducing reliance on TPN.

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