Nursing Elites

1. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?

• A. Surgical therapy is indicated.
• B. Place the infant in a prone position for sleep after feeding.
• C. Thicken feedings and enlarge the nipple hole.
• D. Reduce the frequency of feeding by encouraging larger volumes of formula.

Correct answer: C

Rationale: The correct recommendation for decreasing the number and total volume of emesis in an infant with gastroesophageal reflux is to thicken feedings and enlarge the nipple hole. Thicker feedings can reduce the frequency and volume of emesis by making the food less likely to be regurgitated. Enlarging the nipple hole helps ensure the thickened feedings can pass through. Surgical therapy (Choice A) is not the initial recommendation for managing gastroesophageal reflux in infants. Placing the infant in a prone position for sleep after feeding (Choice B) is not recommended due to the increased risk of sudden infant death syndrome (SIDS). Reducing the frequency of feeding by encouraging larger volumes of formula (Choice D) can exacerbate the reflux symptoms.

2. What is a key distinguishing feature of bronchiolitis in infants?

• A. Dry cough
• B. Wheezing
• C. Stridor
• D. Productive cough

Correct answer: B

Rationale: The correct answer is B: Wheezing. Wheezing is a key distinguishing feature of bronchiolitis in infants, typically caused by respiratory syncytial virus (RSV) infection. Bronchiolitis is characterized by inflammation and mucus buildup in the small airways of the lungs, leading to wheezing sounds during breathing. Choices A, C, and D are incorrect because dry cough, stridor, and productive cough are not typical features of bronchiolitis in infants.

3. What is one focus of current health care?

• A. Increased provision of nursing services
• B. Disease prevention
• C. Symptom management
• D. Identification of disease processes

Correct answer: B

Rationale: The correct answer is 'Disease prevention.' Modern healthcare places emphasis on preventing diseases to enhance overall health and well-being. While nursing services, symptom management, and disease identification are crucial components of healthcare, disease prevention plays a key role in reducing the burden of illness on individuals and communities.

4. Play activities of the preschool-age child include:

• A. Having imaginary playmates
• B. Selective collection of objects
• C. Complex board games
• D. Associative play

Correct answer: A

Rationale: The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.

5. Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?

• A. Medical therapy is not effective after this age.
• B. Treatment is necessary to maintain the ability to be fertile when older.
• C. The younger child can tolerate the extensive surgery needed.
• D. Sexual reassignment may be necessary if treatment is not successful.

Correct answer: B

Rationale: Early treatment of cryptorchidism is essential to preserve fertility and prevent complications such as testicular cancer. Surgery is usually well-tolerated, and sexual reassignment is not typically related to this condition.

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