Nursing Elites

1. A healthcare professional is planning care for an infant who has a colostomy. Which of the following actions should the healthcare professional take?

• A. Change the ostomy pouch every day.
• B. Use baby wipes to clean the stoma.
• C. Avoid using soap to clean the stoma.
• D. Apply barrier ointment to the skin around the stoma.

Correct answer: D

Rationale: When caring for an infant with a colostomy, it is essential to apply barrier ointment to the skin around the stoma. This helps in preventing skin breakdown and irritation caused by exposure to stool or urine. Changing the ostomy pouch as needed, using appropriate cleaning supplies such as warm water and mild soap (avoiding harsh chemicals like alcohol), and ensuring gentle cleaning of the stoma with a soft cloth or gauze are also important steps in colostomy care. Using baby wipes may not be recommended as they can contain chemicals that may irritate the sensitive skin around the stoma.

2. The healthcare provider discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching?

• A. My daughter should wash and wipe the perineal area from front to back.
• B. I am only going to have my daughter wear cotton underwear.
• C. It is acceptable to take frequent bubble baths.
• D. She needs to drink lots of fluids and void frequently.

Correct answer: C

Rationale: The statement 'It is acceptable to take frequent bubble baths' indicates a need for further teaching. Oils in bubble bath and similar products can irritate the urethra, potentially leading to recurrent urinary tract infections. The other choices are correct: wiping from front to back helps prevent the spread of bacteria, wearing cotton underwear promotes breathability and reduces moisture, and drinking fluids and voiding frequently help flush out bacteria.

3. The healthcare provider is assessing an infant brought to the clinic due to diarrhea. The infant is alert but has dry mucous membranes. Which additional assessment data indicates to the healthcare provider that the infant is experiencing an early to moderate stage of dehydration?

• A. Bradycardia
• B. Tachycardia
• C. Increased blood pressure
• D. Normal fontanels

Correct answer: B

Rationale: Tachycardia is a common early sign of dehydration in infants, especially when presenting with dry mucous membranes and diarrhea. The increased heart rate is the body's compensatory mechanism to maintain cardiac output in response to dehydration. Bradycardia, increased blood pressure, and normal fontanels are not typically associated with early to moderate dehydration in infants.

4. The healthcare provider is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the healthcare provider to recommend to keep urine acidic?

• A. Milk
• B. Grape juice
• C. Apple juice
• D. Orange juice

Correct answer: C

Rationale: To maintain the acidity of urine and potentially prevent urinary tract infections, juices such as apple or cranberry are recommended due to their ability to create an acidic environment in the urinary tract that may help inhibit bacterial growth.

5. Which standardized test would be most appropriate for assessing the motor development of a 2-month-old infant in a high-risk clinic?

• A. Peabody Developmental Motor Scale (PDMS-2)
• B. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2)
• C. Pediatric Evaluation of Disability Index (PEDI)
• D. School Assessment of Motor and Process Skills (School-AMPS)

Correct answer: A

Rationale: The Peabody Developmental Motor Scale (PDMS-2) is specifically designed to assess the motor development of infants and young children, making it the most appropriate choice for evaluating a 2-month-old infant in a high-risk clinic setting.

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