Nursing Elites

1. A parent of an infant with congenital hypothyroidism is receiving teaching from a nurse. Which of the following statements should the nurse include in the teaching?

• A. Your child will need to take medication for a few months
• B. You will need to give your child the medication every other day
• C. Your child will need to take the medication until age 10
• D. Your child will need to take the medication for life

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism requires lifelong medication to manage the condition effectively. The nurse should emphasize to the parent that their child will need to take the medication for life to ensure proper thyroid hormone levels and prevent complications associated with hypothyroidism.

2. What is the recommended sleep duration for 14-17-year-olds?

• A. 14-17 hours
• B. 8-10 hours
• C. 12-15 hours
• D. 9-11 hours

Correct answer: B

Rationale: The recommended sleep duration for adolescents aged 14-17 is 8-10 hours to promote optimal health. Getting enough sleep is crucial for their physical and mental well-being, as it supports growth, development, learning, and overall health.

3. Which assessment finding for a 4-month-old infant would require further action by the nurse?

• A. The posterior fontanel is open.
• B. The infant has good head control when held upright.
• C. The infant is able to roll only from abdomen to back.
• D. The anterior fontanel is open and soft.

Correct answer: A

Rationale: The correct answer is A. The posterior fontanel should be closed by 4 months of age. An open posterior fontanel at this age may indicate a delay in normal closure, which could be a cause for concern and require further evaluation by the healthcare provider to ensure proper development and growth. Choices B, C, and D are typical developmental milestones for a 4-month-old infant and do not raise immediate concerns requiring further action by the nurse.

4. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

• A. Elevate the head of the child's bed
• B. Insert a large-bore IV catheter for the child
• C. Determine the allergen that caused the child's reaction
• D. Administer IM epinephrine to the child

Correct answer: D

Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.

5. An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?

• A. Necrotizing enterocolitis (NEC)
• B. Ulcerative colitis (UC)
• C. Crohn's disease
• D. Appendicitis

Correct answer: B

Rationale: Ulcerative colitis is a type of inflammatory bowel disease characterized by recurrent abdominal pain, diarrhea, and bloody stools. The symptoms described align with the clinical presentation of ulcerative colitis, making it the most likely diagnosis in this scenario. Necrotizing enterocolitis primarily affects premature infants, Crohn's disease typically presents with non-bloody diarrhea, and appendicitis is characterized by right lower quadrant abdominal pain. Therefore, based on the symptoms provided, ulcerative colitis is the most appropriate suspicion.

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