Nursing Elites

1. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

2. In planning the use of resources for secondary prevention in a community clinic serving migrant families, which activity should be the priority?

• A. Skin testing for tuberculosis.
• B. Glucose monitoring for diabetes.
• C. Blood work for cardiovascular disease.
• D. Height and weight for altered nutrition.

Correct answer: A

Rationale: The correct answer is A: Skin testing for tuberculosis. In a community clinic serving migrant families, tuberculosis is a significant health concern due to close living conditions and potential exposure during migration. Skin testing for tuberculosis is crucial for secondary prevention as it helps in early detection and prevention of the spread of the disease within the community. Choices B, C, and D are important health screenings but may not be the priority in this specific population where tuberculosis poses a higher risk.

3. The healthcare professional enters the room as a 3-year-old is having a generalized seizure. Which intervention should the healthcare professional do first?

• A. Clear the area of any hazards
• B. Place the child on the side
• C. Restrain the child
• D. Give the prescribed anticonvulsant

Correct answer: B

Rationale: Placing the child on the side is the priority intervention during a generalized seizure as it helps maintain an open airway and prevents aspiration. Clearing the area of any hazards is important but should come after ensuring the child's safety. Restraining the child is not recommended during a seizure as it can lead to injury. Giving the prescribed anticonvulsant is important but should not be the first action during an ongoing seizure.

4. The family health care plan includes the following listed in sequence:

• A. objective, statement of the problem, intervention, and evaluation
• B. objectives, intervention, evaluation, and statement of the problem
• C. evaluation, statement of the problems, objectives, and interventions
• D. statement of the problems, objectives, intervention, and evaluation

Correct answer: D

Rationale: In a family health care plan, the correct sequence should start with identifying the problems (statement of the problems), setting objectives, planning interventions, and then evaluating the outcomes. This sequence ensures a logical and structured approach to healthcare planning. Choices A, B, and C are incorrect as they do not follow the logical order of healthcare planning steps.

5. What does the infant mortality rate measure?

• A. dying for every thousand of the population
• B. dying from 0-5 years old in every thousand population
• C. dying in the first 4 weeks in every thousand children born alive that year
• D. dying before 1 year old in every thousand children born alive that year

Correct answer: D

Rationale: The infant mortality rate measures the number of deaths occurring before 1 year old per 1000 live births. This is a crucial indicator of a population's health status and access to healthcare for infants. Choices A, B, and C are incorrect because the infant mortality rate specifically focuses on deaths within the first year of life, not the entire population or different age ranges.

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