Nursing Elites

1. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?

• A. Acidosis
• B. Alkalosis
• C. Hyperkalemia
• D. Hypernatremia

Correct answer: B

Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.

2. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. absence of a urethral opening
• B. penis appears shorter than usual for age
• C. the urethral opening is along the dorsal surface of the penis
• D. the urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: Hypospadias is a congenital condition where the urethral opening is located along the ventral surface of the penis, not the dorsal surface (Choice C) or absent (Choice A). This leads to the characteristic appearance of a ventrally displaced urethral meatus. The penis may appear normal in size but with the urethral opening positioned abnormally (Choice D), rather than being shorter than usual (Choice B). Therefore, the correct expectation for a newborn with hypospadias is that the urethral opening is along the ventral surface of the penis, making Choice D the correct answer.

3. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.

4. During postoperative care for a child who has had a tonsillectomy, what is an important nursing intervention?

• A. Encouraging deep breathing exercises
• B. Encouraging the child to eat
• C. Administering antibiotics
• D. Applying ice to the throat

Correct answer: C

Rationale: Administering antibiotics is crucial post-tonsillectomy to prevent infection, as the surgical site is susceptible to bacterial growth. Encouraging deep breathing exercises can also be beneficial for lung expansion and preventing respiratory complications. However, administering antibiotics takes precedence as it directly addresses the risk of infection. Encouraging the child to eat may not be appropriate immediately post-tonsillectomy due to the risk of throat irritation and potential discomfort. Applying ice to the throat is typically not recommended after a tonsillectomy, as it may constrict blood vessels and hinder the healing process.

5. Which of the following findings would indicate altered mental status in a small child?

• A. Recognition of the parents
• B. Fright at the EMT-B's presence
• C. Lack of attention to the EMT-B's presence
• D. Consistent eye contact with the EMT-B

Correct answer: C

Rationale: In small children, altered mental status can manifest as a lack of attention to the presence of unfamiliar individuals, such as the EMT-B. This lack of engagement may indicate confusion, disorientation, or impaired cognitive function. Choices A, B, and D are incorrect as recognizing parents, exhibiting fear, or maintaining consistent eye contact do not necessarily indicate altered mental status. Recognizing parents is a normal response, fear can be a typical reaction to unfamiliar situations, and making eye contact may be a sign of curiosity or comfort rather than a reflection of mental status.

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