Nursing Elites

1. An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for?

• A. Central venous catheter infection, electrolyte losses, and hyperglycemia
• B. Hypoglycemia, catheter migration, and weight gain
• C. Venous thrombosis, hyperlipidemia, and constipation
• D. Catheter damage, red currant jelly stools, and hypoglycemia

Correct answer: A

Rationale: Infants with short bowel syndrome requiring prolonged total parenteral nutrition (TPN) are susceptible to central venous catheter infections, electrolyte losses, and hyperglycemia. Monitoring for these complications is crucial to prevent serious outcomes. Choices B, C, and D are incorrect because they do not reflect the common complications associated with prolonged TPN in infants.

2. The clinic nurse is teaching parents about physiologic anemia that occurs in infants. What statement should the nurse include about the cause of physiologic anemia?

• A. Maternally derived iron stores are depleted in the first 2 months.
• B. Fetal hemoglobin results in a shortened survival of red blood cells.
• C. The production of adult hemoglobin decreases in the first year of life.
• D. Low levels of fetal hemoglobin depress the production of erythropoietin.

Correct answer: B

Rationale: Physiologic anemia is caused by the transition from fetal to adult hemoglobin, with fetal hemoglobin having a shorter lifespan, leading to a temporary decrease in red blood cells.

3. An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?

• A. Renal colic
• B. Strong urinary stream
• C. Urinary tract infections
• D. Post urination dribbling

Correct answer: D

Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.

4. What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

• A. Fever
• B. Hypotension
• C. All are applicable
• D. Swelling and tenderness of graft area

Correct answer: B

Rationale: Signs of kidney transplant rejection include fever, diminished urinary output, and swelling/tenderness in the graft area. These symptoms indicate that the body may be rejecting the transplanted organ, requiring immediate medical attention.

5. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

• A. Limit explanation of procedures because the child is preschool-aged
• B. Ask that all family members leave the room when performing procedures
• C. Allow the child to choose the type of juice to drink with the administration of oral medications
• D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective

Correct answer: C

Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.

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