Nursing Elites

1. When planning the discharge of a child who had surgery for a congenital heart defect, what is an important aspect of the discharge teaching?

• A. Teaching the parents about signs of infection
• B. Providing instructions on wound care
• C. Scheduling follow-up appointments
• D. Explaining the use of prescribed medications

Correct answer: D

Rationale: Explaining the use of prescribed medications is crucial because it helps ensure proper management of the child’s condition after discharge. While teaching the parents about signs of infection and providing instructions on wound care are important aspects of postoperative care, they are not as critical as ensuring the correct understanding and administration of prescribed medications. Scheduling follow-up appointments is also important but does not directly impact the immediate post-discharge care and medication adherence.

2. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

• A. Avoid dairy products
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid foods high in sugar

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

3. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?

• A. It limits the chance of vomiting.
• B. It allows the feeding to be administered rapidly.
• C. The energy that would have been expended on sucking is conserved.
• D. The quantity of nutritional liquid can be regulated better than with a bottle.

Correct answer: C

Rationale: Gavage feedings are necessary for infants with congenital heart defects to conserve the infant's energy by eliminating the need for sucking. This is important because sucking requires energy expenditure, which can be taxing for infants with cardiac defects. Choice A is incorrect as gavage feedings do not primarily limit the chance of vomiting. Choice B is incorrect because the speed of feeding administration is not the primary reason for using gavage feedings in this case. Choice D is incorrect as the regulation of the quantity of nutritional liquid is not the main purpose of gavage feedings in infants with congenital heart defects.

4. A healthcare professional is assessing a child with suspected bacterial meningitis. What is a common clinical manifestation that the healthcare professional is likely to observe?

• A. Rash
• B. Photophobia
• C. Jaundice
• D. Kernig sign

Correct answer: D

Rationale: A common clinical manifestation of bacterial meningitis is a positive Kernig sign, indicating irritation of the meninges. Rash (Choice A) is not typically associated with bacterial meningitis. Photophobia (Choice B) can be present but is more commonly seen in viral meningitis. Jaundice (Choice C) is not a typical clinical manifestation of meningitis and is more indicative of liver dysfunction.

5. The parents of a 6-week-old infant who was born without an immune system ask a nurse why their baby is still so healthy. How should the nurse reply?

• A. Exposure to pathogens during this time can be limited.
• B. Some antibodies are produced by the infant’s colonic bacteria.
• C. Antibodies are passively received from the mother through the placenta and breast milk.
• D. Fewer antibodies are produced by the fetal thymus during the eighth and ninth months of gestation.

Correct answer: C

Rationale: The correct answer is C. Infants receive passive immunity through antibodies from the mother during pregnancy and breastfeeding, which protect them initially. Choice A is incorrect because a 6-week-old infant born without an immune system would not be able to limit exposure to pathogens effectively. Choice B is incorrect as antibodies produced by colonic bacteria are not a significant source of immunity in infants. Choice D is incorrect as the fetal thymus primarily plays a role in T cell development rather than antibody production during gestation.

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