Nursing Elites

1. 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.

2. 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, what should you do 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, the priority is to relieve pressure from the umbilical cord protruding from the vaginal opening by gently pushing it back inside using your gloved fingers. This action helps prevent cord compression, maintains blood flow to the fetus, and ensures fetal oxygenation. Massaging the uterus (Choice A) is not appropriate in this situation as it can potentially worsen the cord compression. Placing the mother on her left side and providing rapid transport (Choice C) can be considered after relieving the pressure on the cord. Elevating the mother's lower extremities and providing immediate transport (Choice D) is not the correct approach when dealing with a visible umbilical cord; instead, the focus should be on relieving pressure from the cord to prevent fetal compromise.

3. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

4. A group of students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?

• A. Regulation of water balance
• B. Hormonal secretion
• C. Cellular metabolism
• D. Growth stimulation

Correct answer: B

Rationale: The primary function of the endocrine system is hormonal secretion. This system is responsible for producing and releasing hormones that regulate various bodily functions such as growth, metabolism, and mood. Choice A, regulation of water balance, is more related to the functions of the renal system rather than the endocrine system. Choice C, cellular metabolism, is a general cellular process that involves various systems, not specific to the endocrine system. Choice D, growth stimulation, though hormones can influence growth, it is not the primary function of the endocrine system. Therefore, the correct answer is B.

5. A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area?

• A. Growth plate.
• B. Epiphysis.
• C. Physis.
• D. Metaphysis.

Correct answer: B

Rationale: The correct answer is B: Epiphysis. Bone growth primarily occurs in the epiphysis, which is the area where growth plates are located. The epiphysis is responsible for longitudinal bone growth. Choice A, 'Growth plate,' is incorrect as it does not specify the exact area where bone growth primarily occurs. Choice C, 'Physis,' refers to the same structure as a growth plate, but the term 'epiphysis' is more specific to bone growth. Choice D, 'Metaphysis,' is incorrect as it is the area of the bone where the epiphysis meets the diaphysis, not the primary site of bone growth.

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