Nursing Elites

1. When caring for a child and family who just moved out of a dangerous neighborhood, which of the following approaches is appropriate to the family stress theory?

• A. Determining who the decision maker is
• B. Assessing the child's coping abilities
• C. Finding out how siblings feel
• D. Explaining procedures to siblings

Correct answer: B

Rationale: Assessing the child's coping abilities is appropriate when applying the family stress theory because it helps understand how well the child is managing the stress of the situation. This assessment can provide insights into the child's emotional well-being and resilience, enabling healthcare providers to offer appropriate support. Choices A, C, and D are less relevant in the context of family stress theory. Determining who the decision-maker is may be important but is not directly related to assessing the child's coping abilities. Finding out how siblings feel and explaining procedures to siblings may be valuable aspects of care but are not specifically aligned with the core principles of the family stress theory, which focus on understanding and addressing stress within the family unit.

2. What should the nurse advise the parents of a child with asthma on preventing asthma attacks?

• A. Avoid exposure to allergens
• B. Encourage regular exercise
• C. Provide a high-protein diet
• D. Increase fluid intake

Correct answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.

3. What definitive diagnostic procedure does the nurse expect to be used to confirm the diagnosis of Hirschsprung disease in a 1-month-old infant?

• A. Colonoscopy
• B. Rectal biopsy
• C. Multiple saline enemas
• D. Fiberoptic nasoenteric tube

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. This procedure reveals the absence of ganglion cells in the affected bowel segment, which is a hallmark of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for diagnosing Hirschsprung disease due to the risk of not accurately reaching the affected segment. Multiple saline enemas (Choice C) are not used to confirm the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a standard diagnostic procedure for Hirschsprung disease and does not provide the necessary information to confirm the absence of ganglion cells in the affected bowel segment.

4. A child who had surgery for a congenital heart defect is being discharged. What is an important aspect of the discharge teaching?

• A. Teaching the parents about signs of infection
• B. Providing instructions on wound care
• C. Scheduling follow-up appointments
• D. Explaining the use of prescribed medications

Correct answer: D

Rationale: Explaining the use of prescribed medications is crucial as it helps ensure the proper management of the child's condition post-discharge. Understanding how and when to administer medications is essential for the child's recovery. While teaching the parents about signs of infection, providing wound care instructions, and scheduling follow-up appointments are also important aspects of care, ensuring the correct use of prescribed medications takes precedence to prevent complications and promote the child's well-being.

5. Your assessment of a mother in active labor reveals that a limb is protruding from the vagina. Management of this condition should include:

• A. Positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport
• B. Positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport
• C. Applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord
• D. Giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur

Correct answer: B

Rationale: In a situation where a limb is protruding from the vagina during active labor, the correct management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord and improves oxygenation to the fetus. Administering oxygen is important to ensure adequate oxygen supply to both the mother and the baby. Providing transport is necessary for prompt transfer to a medical facility for further management. Applying gentle traction to the protruding limb is not recommended as it can cause harm to the baby and should be avoided. Giving 100% oxygen and attempting to manipulate the protruding limb is not the correct approach and can potentially lead to further complications.

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