Nursing Elites

1. The apnea monitor alarm sounds on a neonate for the third time during this shift. What is the priority action by the nurse?

• A. Provide tactile stimulation.
• B. Administer 100% oxygen.
• C. Investigate possible causes of a false alarm.
• D. Assess infant for color and presence of respirations.

Correct answer: D

Rationale: The priority action for the nurse when the apnea monitor alarm sounds on a neonate is to assess the infant for color and the presence of respirations. This initial assessment helps determine the infant's respiratory status and the need for immediate intervention. Providing tactile stimulation or administering oxygen should only be done after assessing the infant's respiratory status. Investigating possible causes of a false alarm comes after ensuring the infant's well-being through the initial assessment.

2. At what point in the hospitalization of the pediatric patient should discharge planning and teaching begin?

• A. Post-operatively
• B. Right when the patient is being discharged with the parents and support members present
• C. On the morning that the patient is scheduled to go home
• D. On admission

Correct answer: D

Rationale: Discharge planning should begin on admission to ensure that all necessary teaching and preparations are completed in a timely manner. Starting discharge planning early allows for a comprehensive assessment of the patient's needs, coordination with the healthcare team, and adequate time for patient and family education. Choice A, post-operatively, is too late in the process and may lead to rushed planning. Choice B, right at discharge, may not allow enough time for thorough preparation. Choice C, on the morning of discharge, also does not provide sufficient time for effective planning and education.

3. What is the most common piece of medical equipment that can transmit harmful microorganisms among patients?

• A. Thermometer
• B. Stethoscope
• C. Injection needle
• D. Disposable gloves

Correct answer: B

Rationale: The correct answer is B: Stethoscope. A stethoscope is commonly used between patients, and if not correctly disinfected, it can be a dangerous source of spreading microorganisms. Thermometers typically have barriers to prevent this type of transmission. Injection needles are discarded immediately after use and not reused, making them an unlikely source of transmission. Similarly, disposable gloves are not reused, so they are also not a common source of harmful microorganism transmission.

4. The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)

• A. Encourage fluids.
• B. Monitor urinary output.
• C. Monitor sodium serum levels.
• D. All above

Correct answer: D

Rationale: Gentamicin is an aminoglycoside antibiotic that requires monitoring of serum peak and trough levels to avoid toxicity, particularly nephrotoxicity and ototoxicity. Encouraging fluids and monitoring urinary output are also crucial to minimize the risk of kidney damage.

5. The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?

• A. Empty the mouth of pills, plants, or other material.
• B. Question the victim and witness.
• C. Place the child in a side-lying position.
• D. Call poison control.

Correct answer: D

Rationale: After ensuring the child's immediate survival needs are met with CPR, contacting poison control is critical to receive specific guidance on how to proceed with treatment. Other actions may be necessary depending on the situation but should follow contacting poison control.

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