Nursing Elites

1. When teaching parents about preventing childhood obesity, what should the nurse recommend?

• A. Encourage high-calorie snacks
• B. Limit screen time
• C. Encourage fast food as a treat
• D. Allow the child to eat freely

Correct answer: B

Rationale: Limiting screen time is a crucial recommendation to prevent childhood obesity. Excessive screen time is associated with sedentary behavior and increased consumption of unhealthy snacks, leading to weight gain. Encouraging high-calorie snacks (Choice A) contradicts the goal of preventing obesity. While fast food as a treat (Choice C) can be consumed occasionally, it should not be encouraged as a regular practice. Allowing the child to eat freely (Choice D) without restrictions can lead to overeating and unhealthy dietary habits, contributing to obesity risk.

2. The nurse notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. This is most likely the result of

• A. poor appetite
• B. increased potassium intake
• C. reduction of edema
• D. restriction to bed rest

Correct answer: C

Rationale: The correct answer is C: reduction of edema. In acute glomerulonephritis, weight loss is often a result of the reduction of edema. Acute glomerulonephritis causes fluid retention and edema due to kidney inflammation. As the inflammation resolves with treatment, the kidneys can excrete excess fluid, leading to weight loss. Choices A, B, and D are incorrect. Poor appetite, increased potassium intake, and restriction to bed rest are not typically the primary reasons for weight loss in acute glomerulonephritis.

3. A child with a diagnosis of sickle cell anemia is admitted to the hospital with a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, the priority nursing intervention is administering pain medication. Pain management is crucial to alleviate the intense pain experienced by the child. While administering oxygen can help improve oxygenation, it is not the most critical intervention during a vaso-occlusive crisis. Monitoring fluid intake is important for overall care but is not the immediate priority during a crisis. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can worsen the pain and the crisis itself.

4. 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.

5. 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.

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