Nursing Elites

1. The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?

• A. Heat only 10 oz or more.
• B. Do not thaw or heat breast milk in a microwave oven.
• C. Always leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Thawing or heating breast milk in a microwave is not recommended because it can create hot spots that may burn the infant and destroy essential nutrients.

2. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

• A. Postpone starting the IV until the next shift.
• B. Start the IV line and then allow for expression of feelings.
• C. Change the route of the antibiotics to PO.
• D. Postpone starting the IV line until the child is ready.

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

3. The physician tells the parents of a 2-year-old that the child probably has RSV. The parents ask how the diagnosis will be confirmed. How should the nurse respond?

• A. We will swab your child's nose and send the secretions for testing.
• B. There is no specific test for RSV. The diagnosis is based on symptoms.
• C. We will send a viral culture to an outside lab for testing.
• D. There is no specific test for RSV. The diagnosis is based on symptoms.

Correct answer: A

Rationale: The correct answer is A. RSV is typically diagnosed by swabbing the nose and testing the secretions. This method helps confirm the presence of the respiratory syncytial virus. Choice B is incorrect because while symptoms are important in diagnosis, specific tests like swabbing for RSV do exist. Choice C is incorrect as sending a viral culture to an outside lab is not the primary method for diagnosing RSV. Choice D is a duplicate of choice B and is incorrect for the same reasons.

4. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

• A. Chromosome analysis will be complete in 7 days.
• B. A physical examination will be able to provide a definitive answer.
• C. Additional laboratory testing is necessary to assign the correct gender.
• D. Gender assignment involves collaboration between the parents and a multidisciplinary team.

Correct answer: D

Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.

5. A 12-year-old child had an appendectomy 18 hours ago. The nurse is monitoring the child for pain control. Which of the following tools is most appropriate for assessing the child’s pain?

• A. FLACC scale
• B. Numeric scale
• C. NIPS scale
• D. FACES scale

Correct answer: B

Rationale: The Numeric scale is the most appropriate tool for assessing pain in older children, like a 12-year-old, as they can comprehend and use numbers to indicate their pain levels accurately. The FLACC scale is typically used for nonverbal or preverbal children. The NIPS scale is designed for neonates and infants. The FACES scale is more commonly used in younger children who may have difficulty expressing their pain in other ways.

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