Nursing Elites

1. Why should a nurse plan an evening snack for a child receiving Novolin N insulin?

• A. To encourage the child to adhere to the diet.
• B. To provide energy for immediate use.
• C. To help the child gain weight with extra calories.
• D. To counteract late insulin activity with nourishment.

Correct answer: D

Rationale: The correct answer is D. Novolin N insulin peaks in the evening, which can lead to hypoglycemia during the night. Providing an evening snack helps to counteract the late insulin activity and prevent hypoglycemia. Choice A is incorrect because the primary reason for the evening snack is not to encourage adherence to the diet. Choice B is incorrect as the snack is not primarily for immediate energy use. Choice C is incorrect as the goal of the snack is not to help the child gain weight but to manage blood sugar levels.

2. A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What should the nurse recommend the parent do?

• A. Administer syrup of ipecac.
• B. Call the poison control center.
• C. Take the child to the emergency department.
• D. Give the child bread dipped in milk to absorb the poison.

Correct answer: B

Rationale: In cases of potential poisoning, the best immediate action to take is to call the poison control center. Administering syrup of ipecac is no longer recommended as it can lead to complications such as aspiration and may interfere with subsequent treatments. Taking the child to the emergency department should only be done if advised by the poison control center or if the child is showing severe symptoms. Giving bread dipped in milk to absorb the poison is not an appropriate or effective treatment for poisoning, as it does not address the toxicity of the ingested substance and may delay appropriate medical interventions.

3. A nurse is assessing the oral cavity of a 6-month-old infant. The parent asks which teeth will erupt first. How should the nurse respond?

• A. Incisors
• B. Canines
• C. Upper molars
• D. Lower molars

Correct answer: A

Rationale: The correct answer is A: Incisors. In infants, incisors are usually the first teeth to erupt, typically around 6 months of age. These are the front teeth used for cutting food. Canines (Choice B), upper molars (Choice C), and lower molars (Choice D) typically erupt after the incisors. Canines are sharp teeth used for tearing food, while molars are flat teeth used for grinding food.

4. A 3-year-old child with a history of frequent respiratory infections is being evaluated for cystic fibrosis. What diagnostic test should the nurse anticipate will be ordered?

• A. Chest X-ray
• B. Sweat chloride test
• C. Pulmonary function test
• D. Sputum culture

Correct answer: B

Rationale: The correct answer is the sweat chloride test. This test is crucial in diagnosing cystic fibrosis as it measures the amount of chloride in sweat, which is typically elevated in individuals with cystic fibrosis. A chest X-ray (Choice A) may show characteristic findings like hyperinflation or bronchiectasis, but it is not a definitive diagnostic test for cystic fibrosis. Pulmonary function tests (Choice C) may help assess lung function but are not specific for cystic fibrosis. Sputum culture (Choice D) may be used to identify specific pathogens causing respiratory infections but is not a primary diagnostic test for cystic fibrosis.

5. While performing a visual inspection of a 30-year-old woman in active labor, you can see the umbilical cord at the vaginal opening. After providing high concentration oxygen, you should next

• A. massage the uterus to facilitate delivery of the fetus
• B. relieve pressure from the cord with your gloved fingers
• C. place the mother on her left side and provide rapid transport
• D. elevate the mother's lower extremities and provide immediate transport

Correct answer: B

Rationale: In the scenario described, when the umbilical cord is visible at the vaginal opening, the priority is to relieve pressure from the cord with gloved fingers. This action helps prevent cord compression and ensures continued oxygenation to the fetus, which is crucial for the baby's well-being. Massaging the uterus or elevating the mother's lower extremities is not the correct course of action in this situation and may potentially worsen the condition. Placing the mother on her left side and providing rapid transport is not the immediate step needed to address the visible umbilical cord; relieving pressure from the cord takes precedence to maintain fetal oxygen supply.

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