Nursing Elites

1. A nurse admits a 3-week-old infant to the special care nursery with a diagnosis of bronchopulmonary dysplasia. As the nurse reviews the birth history, which data would be most consistent with this diagnosis?

• A. Gestational age assessment suggested growth retardation
• B. Meconium was cleared from the airway at delivery
• C. Phototherapy was used to treat Rh incompatibility
• D. The infant received mechanical ventilation for 2 weeks

Correct answer: D

Rationale: The correct answer is 'The infant received mechanical ventilation for 2 weeks.' Bronchopulmonary dysplasia is a condition primarily caused by therapies like positive-pressure ventilation used in the treatment of lung disease. This leads to lung damage and subsequent respiratory problems. Choices A, B, and C are not consistent with the diagnosis of bronchopulmonary dysplasia. Gestational age assessment suggesting growth retardation is more indicative of intrauterine growth restriction, clearing meconium from the airway at delivery is related to potential respiratory issues at birth, and phototherapy for Rh incompatibility is unrelated to bronchopulmonary dysplasia.

2. The parents of a newborn with a cleft lip are concerned and ask the nurse when the lip will be repaired. With which statement should the nurse respond?

• A. Cleft lip cannot be repaired.
• B. Cleft-lip repair is usually performed by 6 months of age.
• C. Cleft-lip repair is usually performed during the first months of life.
• D. Cleft-lip repair is usually performed between 6 months and 2 years.

Correct answer: C

Rationale: Cleft-lip repair is typically performed during the first few months of life to address functional and cosmetic concerns at an early stage. Early repair can enhance bonding and facilitate feeding. While revisions may be necessary later on, addressing the cleft lip early is essential. Option A is incorrect as cleft lip repair is a common surgical procedure. Option B is incorrect as repair is typically done earlier than 6 months for better outcomes. Option D is incorrect as the usual timing for repair is within the first months of life, not between 6 months and 2 years.

3. A child is diagnosed with a Greenstick Fracture. Which of the following most accurately describes the broken bone?

• A. compound fracture of the fibula
• B. a partial break in a long bone
• C. fracture of the growth plate of the ulna near the wrist
• D. Colles fracture of the tibia

Correct answer: B

Rationale: A Greenstick Fracture is commonly found in children due to their bones being more flexible. This type of fracture occurs when a bone bends and partially breaks, resembling what happens when a green stick from a tree is bent in half. Therefore, the most accurate description of a Greenstick Fracture is 'a partial break in a long bone.' Choice A, 'compound fracture of the fibula,' is incorrect as a Greenstick Fracture is not a compound fracture. Choice C, 'fracture of the growth plate of the ulna near the wrist,' is incorrect as it describes a different type of fracture. Choice D, 'Colles fracture of the tibia,' is incorrect as it refers to a specific type of fracture in a different bone.

4. The mother of a child who had a cleft palate repair 4 days ago is receiving home care instructions. Which statement by the mother indicates the need for further instruction?

• A. ''I will use a short nipple on the bottle.''
• B. ''I should avoid using straws for drinking.''
• C. ''I can give my child the pacifier in 2 weeks.''
• D. ''I may give my baby food mixed with water.''

Correct answer: B

Rationale: The correct answer is ''I should avoid using straws for drinking.'' After a cleft palate repair, the child should avoid straws, pacifiers, spoons, and fingers near the mouth for 7 to 10 days to prevent injury to the surgical site. Allowing the child to use a straw can create negative pressure in the mouth, potentially disrupting the healing process. The other options are appropriate postoperative instructions for a child who had a cleft palate repair and do not pose a risk to the surgical site.

5. A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate?

• A. Is there any history of IV drug use?
• B. Do you use any over-the-counter drugs?
• C. Are you taking corticosteroids for any reason?
• D. Have you recently traveled to a foreign country?

Correct answer: B

Rationale: The most appropriate question for the nurse to ask in this scenario is whether the patient uses any over-the-counter drugs. The patient's symptoms, negative serologic testing for viral hepatitis, and sudden onset of symptoms point towards toxic hepatitis, which can be triggered by commonly used over-the-counter medications like acetaminophen (Tylenol). Asking about IV drug use is relevant for viral hepatitis, not toxic hepatitis. Inquiring about recent travel to a foreign country is more pertinent to potential exposure to infectious agents causing viral hepatitis. Corticosteroid use is not typically associated with the symptoms described in the case.

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