Nursing Elites

1. Why does a cleft lip predispose an infant to infection, concerning a nurse caring for the infant?

• A. Waste products accumulate along the defect.
• B. There is inadequate circulation in the defective area.
• C. Nutrition is inadequate due to ineffective feeding.
• D. Mouth breathing dries the oropharyngeal mucous membranes.

Correct answer: D

Rationale: Mouth breathing due to a cleft lip can dry the mucous membranes, increasing their susceptibility to infection. While waste product accumulation (Choice A) and inadequate circulation (Choice B) may contribute to complications, they are not directly related to infection in this context. Inadequate nutrition (Choice C) may affect overall health but is not the primary reason for infection predisposition in this case.

2. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order?

• A. Corticosteroids.
• B. Antifungals.
• C. Antibiotics.
• D. Retinoids.

Correct answer: B

Rationale: The correct answer is B: Antifungals. Candidal diaper rash is caused by a yeast infection and is best treated with antifungal agents. Corticosteroids (choice A) may worsen fungal infections by suppressing the immune response. Antibiotics (choice C) are used to treat bacterial infections, not fungal infections like candidal diaper rash. Retinoids (choice D) are not typically used to treat candidal diaper rash in infants; they are more commonly used for dermatological conditions like acne.

3. The nurse is caring for a 3-day-old girl with Down syndrome whose mother had no prenatal care. What is the priority nursing diagnosis?

• A. Imbalanced nutrition, less than body requirements related to the effects of hypotonia
• B. Deficient knowledge related to the presence of a genetic disorder
• C. Delayed growth and development related to cognitive impairment
• D. Impaired physical mobility related to poor muscle tone

Correct answer: A

Rationale: The priority nursing diagnosis for a newborn with Down syndrome is often related to feeding difficulties due to hypotonia, making imbalanced nutrition the primary concern. Hypotonia, or poor muscle tone, can lead to challenges with feeding and, subsequently, affect the baby's nutritional intake. While choices B, C, and D may also be concerns for a child with Down syndrome, addressing the immediate need for adequate nutrition takes precedence to ensure the infant's well-being and growth.

4. A child who had surgery for a congenital heart defect is being discharged. 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 as it helps ensure the proper management of the child's condition post-discharge. Understanding how and when to administer medications is essential for the child's recovery. While teaching the parents about signs of infection, providing wound care instructions, and scheduling follow-up appointments are also important aspects of care, ensuring the correct use of prescribed medications takes precedence to prevent complications and promote the child's well-being.

5. A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the healthcare provider expect?

• A. Proteinuria
• B. Peripheral edema
• C. Elevated hematocrit
• D. Absence of pedal pulses

Correct answer: C

Rationale: In a congenital cardiac malformation causing right-to-left shunting, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not typically associated with congenital cardiac malformations causing right-to-left shunting. Peripheral edema (Choice B) is more commonly seen in conditions causing left-sided heart failure. Absence of pedal pulses (Choice D) is not a typical finding in congenital cardiac malformations causing right-to-left shunting.

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