Nursing Elites

1. A mother delivers an infant at 30 weeks gestation and asks if formula is better than breast milk since the baby is premature. What should the nurse respond?

• A. Human milk is preferred over other types of nutrition
• B. Human milk lacks essential nutrients for preterm infants
• C. Commercial infant formulas are preferred for preterm infants
• D. Commercial formulas have not been designed to meet preterm infants' needs

Correct answer: A

Rationale: Human milk is preferred, even for preterm infants, because it contains essential nutrients and antibodies that are particularly beneficial for their growth and development. Choice B is incorrect because human milk is rich in essential nutrients necessary for preterm infants. Choice C is incorrect as commercial infant formulas do not provide the same benefits as human milk. Choice D is incorrect as specialized formulas are available to meet the unique nutritional needs of preterm infants, but human milk remains the optimal choice.

2. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

3. Which pediatric condition is most likely to present with a "whooping" sound during coughing?

• A. Croup
• B. Bronchitis
• C. Pertussis
• D. Asthma

Correct answer: C

Rationale: The correct answer is C: Pertussis. Pertussis, also known as whooping cough, is characterized by a "whooping" sound during coughing episodes. This distinctive sound is due to the rapid intake of air after a series of coughs. Choice A, Croup, typically presents with a barking cough and stridor. Choice B, Bronchitis, is characterized by a productive cough with mucus. Choice D, Asthma, usually presents with wheezing and shortness of breath.

4. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

5. Which of the following is a hallmark sign of intussusception in children?

• A. Bilious vomiting
• B. "Currant jelly" stools
• C. Abdominal distention
• D. Constipation

Correct answer: B

Rationale: "Currant jelly" stools, consisting of mucus and blood, are characteristic of intussusception in children. It occurs due to the telescoping of a segment of the intestine into an adjacent segment, leading to obstruction and subsequent mucosal ischemia, causing the passage of bloody mucus in the stool. Bilious vomiting can be seen in other conditions like bowel obstruction, abdominal distention can be present but is not as specific, and constipation is less likely in the presentation of intussusception.

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