Nursing Elites

1. After a child returns from surgery for a tracheostomy, what is the priority nursing action?

• A. Suctioning the tracheostomy tube
• B. Changing the tracheostomy dressing
• C. Monitoring respiratory status
• D. Ensuring the tracheostomy ties are secure

Correct answer: A

Rationale: The priority nursing action after a tracheostomy surgery is to suction the tracheostomy tube. Suctioning helps maintain a clear airway and prevent complications such as airway obstruction or respiratory distress. While monitoring respiratory status is important, suctioning takes precedence immediately post-surgery to ensure adequate air exchange. Changing the tracheostomy dressing and ensuring tracheostomy ties are secure are also essential tasks but are secondary to the critical need for airway maintenance through suctioning.

2. How should a nurse prepare a 15-month-old child diagnosed with hydrocephalus for a computed tomography (CT) scan?

• A. Shaving the child's head
• B. Starting the prescribed IV infusion
• C. Administering the prescribed sedative
• D. Giving the child a simple explanation of the procedure

Correct answer: D

Rationale: Preparing a toddler for a CT scan involves providing a simple explanation of the procedure to help reduce anxiety and fear. Shaving the child's head is unnecessary for a CT scan and may increase distress. Starting an IV infusion or administering sedatives may not be appropriate or necessary for all pediatric patients undergoing CT scans, especially if the child can cooperate without these interventions.

3. The instructor is educating a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?

• A. Myelination continues into adolescence.
• B. The process occurs in a head-to-toe fashion.
• C. Myelination speeds up nerve impulses.
• D. Myelination increases the specificity and efficiency of nerve impulses.

Correct answer: B

Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect because myelination continues beyond 4 years of age and into adolescence. Choice C is incorrect as myelination speeds up nerve impulses rather than slowing them down. Choice D is incorrect because myelination increases the specificity and efficiency of nerve impulses, making them more focused and precise.

4. A group of students is reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state:

• A. Endocrine glands begin developing during gestation.
• B. Endocrine glands are fully functional at birth.
• C. Infants may have difficulty regulating glucose and electrolytes.
• D. A child’s endocrine system plays a significant role in growth and development.

Correct answer: C

Rationale: The correct answer is C. Infants may have difficulty regulating glucose and electrolytes due to their immature endocrine systems. This can lead to issues such as hypoglycemia and electrolyte imbalances. Choice A is incorrect because endocrine glands actually begin developing early in gestation, not just in the third trimester. Choice B is incorrect as endocrine glands are not fully functional at birth; they continue to mature and develop after birth. Choice D is incorrect as a child's endocrine system has a significant impact on growth and development through the secretion of hormones that regulate various processes in the body, but it does not specifically address the difficulty in regulating glucose and electrolytes seen in infants.

5. The nurse is assessing an infant and notes that the infant's urine has a mousy or musty odor. What would the nurse suspect?

• A. Maple syrup urine disease
• B. Tyrosinemia
• C. Phenylketonuria
• D. Trimethylaminuria

Correct answer: C

Rationale: The correct answer is C: Phenylketonuria (PKU). PKU is suggested by a mousy or musty odor of the urine, which is caused by the inability to metabolize phenylalanine. Choice A, Maple syrup urine disease, is characterized by a sweet-smelling urine. Choice B, Tyrosinemia, typically presents with cabbage-like odor in the urine. Choice D, Trimethylaminuria, is associated with a fishy odor in the urine, breath, and sweat.

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