Nursing Elites

1. Fred, a 12-year-old boy, is diagnosed with pneumococcal pneumonia. Which of the following symptoms would Nurse Nica expect to assess?

• A. Mild cough
• B. Slight fever
• C. Chest pain
• D. Bulging fontanel

Correct answer: C

Rationale: Chest pain is a common symptom associated with pneumococcal pneumonia. It can occur due to inflammation of the pleura or irritation of the lung tissue, leading to sharp or stabbing pain that worsens with breathing or coughing. While cough and fever are also common with pneumonia, chest pain is particularly significant in this case.

2. What intervention should the nurse encourage for a postpartum client complaining of perineal pain?

• A. Use of ice packs for the first 24 hours
• B. Application of heat packs immediately
• C. Avoiding the use of peri-bottles
• D. Using tampons to manage lochia

Correct answer: A

Rationale: The correct intervention for perineal pain in a postpartum client is the use of ice packs for the first 24 hours. Ice packs help reduce swelling and discomfort in the perineal area, especially during the initial post-delivery period. Applying heat packs can exacerbate swelling and discomfort. Avoiding peri-bottles may lead to poor perineal hygiene. Using tampons is contraindicated postpartum as it increases the risk of infection.

3. How can a new mother tell if her baby is getting enough breast milk?

• A. If your baby sleeps through the night, they are getting enough milk.
• B. If your baby has six to eight wet diapers a day, they are getting enough milk.
• C. If your baby cries frequently, they are getting enough milk.
• D. If your baby is awake and alert, they are getting enough milk.

Correct answer: B

Rationale: The correct answer is B. If a new mother observes that her baby has six to eight wet diapers a day, it indicates that the baby is getting enough breast milk. This is a crucial indicator of adequate milk intake and hydration in infants. Conversely, choices A, C, and D are incorrect. A baby sleeping through the night, crying frequently, or being awake and alert are not reliable indicators of sufficient breast milk intake. It is essential for new mothers to track their baby's diaper output to ensure they are receiving the necessary nutrition.

4. A new mother asks the nurse when she should begin to breastfeed her newborn. The nurse's best response is:

• A. Within the first half-hour after birth
• B. After the newborn's first bath
• C. When the newborn begins to cry
• D. After administering vitamin K

Correct answer: A

Rationale: Initiating breastfeeding within the first half-hour after birth is crucial for successful breastfeeding and bonding, as recommended by the World Health Organization. This early initiation helps establish breastfeeding and supports the newborn's health by providing colostrum, the nutrient-rich first milk. Choice B, 'After the newborn's first bath,' is incorrect because initiating breastfeeding should not be delayed after birth. Choice C, 'When the newborn begins to cry,' is incorrect as it does not promote timely initiation of breastfeeding. Choice D, 'After administering vitamin K,' is incorrect because breastfeeding initiation should not be delayed for this procedure.

5. A 6-year-old child is admitted to the hospital with pneumonia. An immediate priority in this child's nursing care would be:

• A. Elimination
• B. Exercise
• C. Nutrition
• D. Rest

Correct answer: D

Rationale: Rest is crucial for recovery in a child with pneumonia as it allows the body to focus its energy on fighting the infection and promoting healing. Adequate rest helps reduce the workload on the lungs, promotes oxygenation, and supports the immune system's response to combat the infection. It is essential to prioritize rest to facilitate a faster recovery and prevent complications in children with pneumonia.

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