Nursing Elites

1. When administering IV fluids to a dehydrated infant, what intervention is most important at this time?

• A. Continuing the prescribed flow rate
• B. Monitoring the intravenous drop rate
• C. Calculating the total necessary intake
• D. Maintaining the fluid at body temperature

Correct answer: B

Rationale: Monitoring the intravenous drop rate is the most crucial intervention when administering IV fluids to a dehydrated infant. This ensures that the correct amount of fluids is being delivered to the infant at the appropriate rate. While continuing the prescribed flow rate (Choice A) may be important, it does not allow for real-time adjustments that may be necessary during the infusion. Calculating the total necessary intake (Choice C) should have been determined before initiating IV therapy. Maintaining the fluid at body temperature (Choice D) is important for patient comfort but is not as critical as ensuring the proper administration of fluids.

2. The nurse is obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism. What would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism in infants often leads to lethargy and difficulty staying awake due to low thyroid hormone levels. Assessing the child's ability to stay awake is crucial in identifying signs of hypothyroidism. Choices A, B, and C are incorrect because above-normal growth, being active and playful, and having healthy-looking skin are not typical manifestations of congenital hypothyroidism. Instead, infants with hypothyroidism may exhibit poor weight gain, decreased activity, and dry, pale skin.

3. Why is it recommended that closure of the palate should be done before the age of 2 for an 11-month-old infant with a cleft palate?

• A. “After the age of 2, surgery becomes frightening and should be avoided if possible.”
• B. “The eruption of the 2-year molars often complicates the surgical procedure.”
• C. “As your child grows older, the palate widens, making repair more challenging.”
• D. “Surgery should be performed before your child begins to use faulty speech patterns.”

Correct answer: D

Rationale: It is recommended to perform palate closure surgery before the child starts using faulty speech patterns to prevent the development of speech issues that may be harder to correct later. Delaying surgery until after the age of 2 can lead to the child forming incorrect speech habits, which can be challenging to correct. Choices A, B, and C are incorrect because they do not address the specific concern related to speech development in children with cleft palates.

4. The mother of an 8-year-old girl with a broken arm is the nurturer in the family. Which nursing activity should be focused on her?

• A. Teaching proper care procedures
• B. Dealing with insurance coverage
• C. Determining success of treatment
• D. Transmitting information to family members

Correct answer: A

Rationale: In this scenario, focusing on teaching the mother proper care procedures is crucial. This empowers the mother to provide appropriate care for her daughter's broken arm, promoting optimal healing. Dealing with insurance coverage (Choice B) is important but not the immediate focus for the mother. Determining the success of treatment (Choice C) is typically done by healthcare professionals, not family members. Transmitting information to family members (Choice D) may be beneficial but ensuring the primary caregiver, in this case, the mother, is well-informed and capable of providing care takes precedence.

5. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is maintaining strict NPO (nothing by mouth) status. This is crucial to reduce the risk of aspiration during anesthesia induction and prevent potential complications during surgery. Administering antibiotics may be a part of the treatment plan but is not a preoperative intervention. Encouraging fluid intake is contraindicated preoperatively to avoid delays in surgery and complications related to anesthesia. Monitoring for signs of infection is important postoperatively to assess for any complications that may arise due to the surgical procedure.

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