Nursing Elites

1. When teaching a parent of a toddler with a new prescription for liquid ferrous sulfate, which of the following instructions should the nurse include?

• A. Mix the medication with milk.
• B. Give the medication with orange juice.
• C. Give the medication with meals.
• D. Administer the medication with an antacid.

Correct answer: B

Rationale: The correct answer is to give the medication with orange juice. Orange juice helps increase the absorption of iron from ferrous sulfate. This acidic environment aids in the absorption of iron, making it a suitable choice for administration. Mixing the medication with milk or an antacid may decrease iron absorption, and giving it with meals may not optimize its absorption as effectively as with orange juice.

2. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

• A. Position the newborn in a semi-Fowler position.
• B. Allow the newborn to stay in the nursery for observation.
• C. Offer the newborn pacifier for comfort.
• D. Wrap the newborn in blankets and place in an incubator.

Correct answer: A

Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.

3. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

4. What is functional behavior analysis?

• A. Systematic observation of behavior
• B. Standardized assessment
• C. Multiple choice examination
• D. Parent-teacher questionnaire

Correct answer: A

Rationale: Functional behavior analysis involves systematically observing behavior to understand its function and context. It focuses on identifying the antecedents and consequences that maintain or influence behavior. This systematic observation helps in determining patterns, triggers, and maintaining factors of behavior. Standardized assessments (choice B) involve using specific tools or tests to measure a person's performance or behavior but do not focus on observation. Multiple choice examinations (choice C) and parent-teacher questionnaires (choice D) are not synonymous with functional behavior analysis as they do not involve direct observation of behavior for analysis.

5. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

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