Nursing Elites

1. A new father asks the nurse the reason for placing an ophthalmic ointment in his newborn's eyes. What information should the nurse provide?

• A. Possible exposure to an environmental staphylococcus infection can infect the newborn's eyes and cause visual deficits
• B. The newborn is at risk for blindness from a corneal syphilitic infection acquired from a mother's infected vagina
• C. Treatment prevents tear duct obstruction with harmful exudate from a vaginal birth that can lead to dry eyes in the newborn
• D. State law mandates all newborns receive prophylactic treatment to prevent gonorrheal or chlamydial ophthalmic infection

Correct answer: D

Rationale: The correct answer is D because informing about state law emphasizes the legal requirement and public health rationale behind prophylactic eye treatment to prevent serious infections like gonorrheal or chlamydial ophthalmic infection. Choices A, B, and C are incorrect. Choice A focuses on staphylococcus infection, which is not the primary concern addressed by the prophylactic ointment. Choice B mentions a specific infection acquired from the mother's infected vagina, which is not the main reason for the ophthalmic ointment. Choice C discusses tear duct obstruction and dry eyes, which are not the primary concerns addressed by the prophylactic ointment.

2. A client is being treated for heart failure. What should the nurse monitor to evaluate treatment effectiveness?

• A. Daily weight
• B. Electrolyte levels
• C. Urine output
• D. All of the above

Correct answer: D

Rationale: Monitoring daily weight, electrolyte levels, and urine output is crucial in evaluating treatment effectiveness for heart failure. Daily weight monitoring helps assess fluid retention or loss, changes in electrolyte levels can indicate imbalances affecting heart function, and urine output monitoring provides insights into kidney function and fluid balance. Therefore, all options are essential components in assessing the patient's fluid status and response to treatment, making 'All of the above' the correct answer. Choices A, B, and C are incorrect individually as they only represent partial aspects of monitoring heart failure treatment effectiveness.

3. A 4-year-old with acute lymphocytic leukemia (ALL) is receiving a chemotherapy protocol that includes methotrexate, an antimetabolite. Which information should the nurse provide the parents about caring for their child?

• A. Use sunblock or protective clothing when outdoors.
• B. Include the child in regular outings with the family.
• C. Obtain any childhood vaccinations that are not up-to-date.
• D. Use diluted commercial mouthwash for mouth care.

Correct answer: A

Rationale: The correct answer is to use sunblock or protective clothing when outdoors. Methotrexate can cause photosensitivity, making the child more prone to sunburns and skin damage. Therefore, advising the parents to protect their child's skin from direct sunlight exposure is crucial. Choice B is incorrect because exposing the child to direct sunlight without protection can worsen the photosensitivity caused by methotrexate. Choice C is incorrect as obtaining vaccinations is generally avoided during chemotherapy due to the child's compromised immune system. Choice D is incorrect as commercial mouthwash may contain alcohol, which can be irritating to the child's oral mucosa, especially during chemotherapy.

4. A nurse in a pediatric unit is preparing to administer medication to a child. What should the nurse do to ensure the correct dosage?

• A. Check the child's weight
• B. Verify the medication order with a pharmacist
• C. Consult the child's parents
• D. Double-check the dosage calculations with another nurse

Correct answer: D

Rationale: When administering medication to children, it is crucial to ensure the correct dosage to prevent dosing errors. Double-checking the dosage calculations with another nurse can help verify the accuracy of the prescribed dose, reducing the risk of medication errors. While checking the child's weight (Choice A) is important for dosage calculation, it alone may not ensure the correctness of the dosage. Verifying the medication order with a pharmacist (Choice B) is essential, but it may not directly address the accuracy of dosage calculations. Consulting the child's parents (Choice C) is not a standard practice for verifying medication dosages and should not be solely relied upon for ensuring the correct dosage.

5. The client is being taught about a low-sodium diet. Which food should the client avoid?

• A. Fresh fruits
• B. Canned vegetables
• C. Fresh chicken
• D. Unsalted nuts

Correct answer: B

Rationale: The correct answer is B: Canned vegetables. Canned vegetables are often high in sodium due to the preservation process, so they should be avoided on a low-sodium diet. Fresh fruits (choice A), fresh chicken (choice C), and unsalted nuts (choice D) are all low-sodium options and can be included in a low-sodium diet. It is important to choose fresh or frozen vegetables over canned ones to reduce sodium intake. Fresh chicken and unsalted nuts are also good protein sources that are naturally low in sodium, making them suitable for a low-sodium diet. Therefore, clients following a low-sodium diet should prioritize fresh, whole foods over processed or canned options.

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