Nursing Elites

1. A newborn is admitted to the nursery with a complete bilateral cleft lip and palate. The mother refuses to see or hold her infant. What should the nurse do first?

• A. Restate what the physician has told her about plastic surgery
• B. Suggest holding her baby without making eye contact
• C. Encourage and allow the mother to express her feelings
• D. Recognize and allow the mother to express her feelings

Correct answer: D

Rationale: In this situation, the priority is to acknowledge and validate the mother's feelings, creating a supportive environment for her. Option D is correct as it focuses on recognizing and allowing the mother to express her emotions. This approach can help build trust and facilitate communication. Options A and B are incorrect as they do not address the mother's emotional needs and may come across as dismissive. Option C is less appropriate as it only encourages expression without explicitly recognizing the mother's current emotional state.

2. The nurse understands that blocks to therapeutic communication include what? (Select all that apply.)

• A. Socializing
• B. All are applicable
• C. Using clichés
• D. Defending a situation

Correct answer: B

Rationale: Socializing, using clichés, and defending a situation are all barriers to effective therapeutic communication. Silence is a useful tool in therapeutic communication.

3. When checking the intravenous (IV) site on a child, the nurse should take which action?

• A. Look at the site.
• B. Ask the child if the site hurts.
• C. Look at the site while palpating the area.
• D. Take all the tape off, assess the site, and redress.

Correct answer: C

Rationale: Looking at and palpating the IV site helps assess for signs of infiltration or infection, such as swelling, redness, or pain. Simply looking or asking the child may miss subtle signs, and removing all the tape unnecessarily disrupts the site.

4. Several types of long-term central venous access devices are used. What is a benefit of using an implanted port (e.g., Port-a-Cath)?

• A. You do not need to pierce the skin for access.
• B. It is easy to use for self-administered infusions.
• C. The patient does not need to limit regular physical activity, including swimming.
• D. The catheter cannot dislodge from the port even if the child plays with the port site.

Correct answer: C

Rationale: Implanted ports like the Port-a-Cath are fully implanted under the skin, allowing the child to maintain regular physical activities, including swimming, without the risk of dislodging the catheter. Piercing the skin is still required for access, and self-administration is more complex.

5. Prior to giving a hospitalized pre-schooler an injection, the nurse gives the child’s teddy bear a “shot” first. This method is known as:

• A. Critical play
• B. Role play
• C. Diversionary activity
• D. Dramatic play

Correct answer: D

Rationale: The correct answer is D: Dramatic play. Dramatic play involves children acting out experiences to better understand them and reduce fear. In this scenario, by giving the teddy bear a 'shot' first, the nurse is engaging in dramatic play to help the child comprehend and feel more comfortable with the upcoming injection.\n A: Critical play involves critical thinking and problem-solving, not acting out scenarios.\n B: Role play typically involves pretending to be someone else, not necessarily acting out a specific experience.\n C: Diversionary activity aims to distract or redirect attention, which is different from the purpose of dramatic play in this context.

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