Nursing Elites

1. During an otoscopic examination on an infant, in which direction is the pinna pulled?

• A. Up and back
• B. Up and forward
• C. Down and back
• D. Down and forward

Correct answer: C

Rationale: For infants, the pinna is pulled down and back to straighten the ear canal and allow proper visualization of the tympanic membrane during otoscopic examination.

2. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

3. The nurse is assessing a 3-year-old African American child whose height and weight are at the 20th percentile on the growth chart. What should the nurse recognize?

• A. The data suggest the child requires nutritional intervention
• B. The NCHS charts are accurate for U.S. African American children
• C. A correction factor is used for nonwhite ethnic groups
• D. No assessment can be made until several measurements are plotted over time

Correct answer: B

Rationale: The NCHS growth charts serve as reference guides for all racial or ethnic groups, including African American children. The 20th percentile for height and weight does not indicate nutritional failure but provides a reference point for ongoing assessment. Choice A is incorrect because being at the 20th percentile does not automatically imply the need for nutritional intervention. Choice C is incorrect as there is no correction factor specifically used for nonwhite ethnic groups in this context. Choice D is incorrect as a single measurement at the 20th percentile can provide valuable information for assessment.

4. In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

• A. Limit fluids to reduce reflux.
• B. Give cranberry juice twice a day.
• C. Have siblings examined for VUR.
• D. Surgery is indicated to reverse scarring.

Correct answer: C

Rationale: Siblings should be examined for VUR as it can run in families, and early detection can prevent complications. Limiting fluids is not advisable, and cranberry juice is not effective in preventing VUR. Surgery is usually not indicated for scarring reversal.

5. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

• A. Keep buttons, beads, and other small objects out of his reach.
• B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
• C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
• D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.

Correct answer: A

Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.

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