Nursing Elites

1. In the newborn, into what muscle is intramuscular vitamin K administered?

• A. Deltoid
• B. Dorsogluteal
• C. Rectus femoris
• D. Vastus lateralis

Correct answer: D

Rationale: In newborns, intramuscular vitamin K is traditionally administered into the vastus lateralis muscle. This site is preferred due to its large muscle mass and accessibility. The dorsogluteal site is not recommended for newborns due to the risk of injury to the sciatic nerve. The deltoid site is also not recommended for newborns. The rectus femoris muscle is not commonly used for intramuscular injections in newborns.

2. Physiologically, the child compensates for fluid volume losses by which mechanism?

• A. Inhibition of aldosterone secretion
• B. Hemoconcentration to reduce cardiac workload
• C. Fluid shift from interstitial space to intravascular space
• D. Vasodilation of peripheral arterioles to increase perfusion

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

3. What component should be included in the nutritional management of a child with Crohn's disease?

• A. High fiber
• B. Increased protein
• C. Reduced calories
• D. Herbal supplements

Correct answer: B

Rationale: The correct answer is B: Increased protein. Children with Crohn's disease require a diet high in protein to support growth and tissue repair. High fiber should be avoided as it can exacerbate symptoms of Crohn's disease. Reducing calories can lead to malnutrition, which is detrimental in this condition. Herbal supplements should be used cautiously and only under medical advice as they may interact with medications or worsen symptoms.

4. What should the nurse explain about ringworm?

• A. It is not contagious
• B. It is a sign of uncleanliness
• C. It is expected to resolve spontaneously
• D. It is spread by both direct and indirect contact

Correct answer: D

Rationale: Ringworm is a fungal infection that spreads through direct and indirect contact. Good hygiene practices can help prevent its spread.

5. The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?

• A. Inform toddlers about an upcoming procedure 2 hours before the procedure is to be performed.
• B. Inform school-age children about an upcoming procedure immediately before the procedure is scheduled to occur.
• C. Discourage parent presence during procedures on infants and toddlers.
• D. Use simple diagrams of anatomy and physiology to explain a procedure to a school-age child.

Correct answer: D

Rationale: Using simple diagrams helps school-age children understand what to expect in a procedure, catering to their developmental level and reducing anxiety. Informing toddlers too early can increase anxiety, and parents' presence is generally comforting, not discouraging.

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