Nursing Elites

1. The mother of a 9-month-old girl provides the practical nurse with information about her daughter's diet. Which statement by the mother may indicate why the infant has been diagnosed with iron-deficiency anemia?

• A. She almost never drinks sugary water.
• B. She has been on whole milk for 7 months.
• C. She likes to chew on bread as a snack.
• D. She doesn't like to eat peaches or pears.

Correct answer: B

Rationale: The correct answer is B. Infants should not be given cow's milk before 1 year of age as it can interfere with iron absorption and lead to anemia. Choice A is incorrect as avoiding sugary water is actually a good practice. Choice C is unrelated to iron-deficiency anemia. Choice D, not liking peaches or pears, is also not directly related to iron-deficiency anemia.

2. The nurse provides information about the human papillomavirus (HPV) vaccine to the mother of a 14-year-old adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent at this visit?

• A. Use of protective barriers during sexual activity prevents most strains of HPV infection
• B. Most adolescents are not honest about being sexually active
• C. Not all strains of HPV will be covered if given at a later date
• D. Immunity must be established to prevent future HPV infection and the risk for cervical cancer

Correct answer: D

Rationale: Administering the HPV vaccine helps establish immunity before potential exposure to the virus, reducing the risk of HPV infection and subsequent development of cervical cancer. It is recommended to vaccinate adolescents before they become sexually active for maximum effectiveness. Choice A is incorrect because while protective barriers can reduce the risk, they do not prevent all strains of HPV. Choice B is incorrect and judgmental as it assumes dishonesty without providing relevant information about HPV vaccination. Choice C is incorrect as it downplays the importance of vaccination by suggesting that not all strains are necessary to cover, which is not the case in preventing HPV-related diseases.

3. A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist albuterol (Proventil). The child’s mother tells the nurse that she uses this medication to open her son’s airway when he is having trouble breathing. What is the nurse’s best response?

• A. Recommend that the mother bring the child in for immediate evaluation
• B. Advise the mother that overuse of the drug may cause chronic bronchitis
• C. Assure the mother that she is using the medication correctly
• D. Confirm that the medication helps to reduce airway inflammation

Correct answer: C

Rationale: The correct response is to assure the mother that she is using the medication correctly. Albuterol is a beta-adrenergic agonist that helps open the airways during an asthma attack. By reassuring the mother, the nurse reinforces the correct usage of the medication, which is crucial in managing the child's asthma symptoms effectively. Option A is incorrect because immediate evaluation may not be necessary if the child's symptoms are being managed effectively with albuterol. Option B is incorrect as chronic bronchitis is not typically associated with the overuse of albuterol. Option D is incorrect as albuterol primarily acts as a bronchodilator and does not directly reduce airway inflammation.

4. A child is recovering from an appendectomy. The parent asks when the child can resume normal activities. What is the best response by the nurse?

• A. The child can resume normal activities as soon as they feel up to it
• B. The child should avoid strenuous activities for at least 2 weeks
• C. The child can resume normal activities after the stitches are removed
• D. The child should avoid all physical activities for the next month

Correct answer: B

Rationale: After an appendectomy, it is important for the child to avoid strenuous activities for at least 2 weeks to allow for proper healing. Resuming normal activities too soon can put unnecessary strain on the healing process and increase the risk of complications.

5. The healthcare provider finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the infant is still not breathing, which action should the provider take?

• A. Palpate femoral pulse and check for regularity.
• B. Deliver cycles of 30 chest compressions and 2 breaths.
• C. Give two breaths that make the chest rise.
• D. Feel the carotid pulse and check for adequate breathing.

Correct answer: C

Rationale: In pediatric basic life support, for an unresponsive infant who is not breathing normally, the correct action is to give two breaths that make the chest rise. This helps provide oxygen to the infant's body and is a crucial step in resuscitation efforts for infants in distress. Choices A, B, and D are incorrect. Palpating the femoral pulse or feeling the carotid pulse is not indicated in this scenario where the infant is unresponsive and not breathing. Delivering cycles of chest compressions and breaths is not the immediate action to take; the priority is to provide two breaths to help with oxygenation.

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