Nursing Elites

1. A teenager is accompanied by his mother to the annual physical examination. The nurse is aware of privacy issues related to the teenager. While the mother is in the room, which topic should the nurse avoid?

• A. School performance
• B. Seatbelt use
• C. Cigarette smoking
• D. School friends

Correct answer: C

Rationale: The correct answer is C: Cigarette smoking. Discussing sensitive topics like cigarette smoking in the presence of a parent may inhibit the teenager's willingness to be open and honest. It's important to provide an opportunity for the teenager to speak privately with the healthcare provider. Choices A, B, and D are more general topics that can be discussed openly in front of the parent without compromising the teenager's privacy or comfort.

2. Which term best describes the sharing of common characteristics that differentiate one group from other groups in a society?

• A. Race
• B. Culture
• C. Ethnicity
• D. Superiority

Correct answer: C

Rationale: Ethnicity refers to the shared characteristics such as nationality, culture, language, and beliefs that differentiate one group from another.

3. What interventions would the nurse implement to maintain the skin integrity of a preterm infant born at 30 weeks?

• A. Avoid using alkaline-based soap.
• B. Bathe the infant with sterile water.
• C. Cleanse skin with a gentle alkaline-based soap and water.
• D. Thoroughly rinse skin with plain water after bathing in a mild hexachlorophene solution.

Correct answer: B

Rationale: To maintain the skin integrity of a preterm infant born at 30 weeks, the nurse should bathe the infant with sterile water no more than two or three times per week. The eyes, oral and diaper areas, and pressure points should be cleansed daily. It is essential to avoid using alkaline-based soaps as they might destroy the 'acid mantle' of the skin. Additionally, cleansing with mild solutions and rinsing thoroughly with plain water is recommended to prevent skin irritation and maintain skin integrity. Therefore, options A, C, and D are incorrect as they do not align with the best practices for preterm infant skin care.

4. When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?

• A. At bedtime
• B. With a meal
• C. Midmorning
• D. 30 minutes before breakfast

Correct answer: D

Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.

5. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

• A. Postpone starting the IV until the next shift.
• B. Start the IV line and then allow for expression of feelings.
• C. Change the route of the antibiotics to PO.
• D. Postpone starting the IV line until the child is ready.

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

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