Nursing Elites

1. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

2. What is a suitable nutritional goal for a preschool-aged child?

• A. Minimize messiness and spills.
• B. Introduce new foods gradually and provide variety.
• C. Finish all the food on the plate.
• D. Allow the child to eat only preferred foods.

Correct answer: B

Rationale: Introducing new foods gradually and offering a variety of options is a suitable nutritional goal for preschool-aged children as it helps in providing essential nutrients and expanding their palate. Choice A is incorrect as reducing messiness and spills is more related to behavior than nutrition. Choice C is incorrect as forcing a child to finish all the food on the plate may override their natural hunger and fullness cues. Choice D is incorrect as allowing a child to eat only preferred foods may lead to an imbalanced diet lacking in essential nutrients.

3. The parents of an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?

• A. Your infant will not need any subsequent follow-up care
• B. Your infant will only need to be evaluated by an audiologist
• C. Your infant will only need follow-up with a speech pathologist
• D. Your infant will need follow-up with audiologists and orthodontists

Correct answer: D

Rationale: After cleft palate repair, the child will need ongoing follow-up with audiologists, speech pathologists, and orthodontists to monitor hearing, speech development, and dental alignment.

4. The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death?

• A. Preschoolers
• B. Young school age
• C. Middle school age
• D. Late school age and adolescents

Correct answer: D

Rationale: Suicide is the third leading cause of death in late school-age children and adolescents, requiring careful assessment for ideation in these age groups.

5. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

• A. Initiating breast or bottle-feedings to stabilize the blood glucose level
• B. Maintaining pain management with an intravenous opioid
• C. Covering the intact bowel with a nonadherent dressing to prevent injury
• D. Performing immediate surgery

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

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