Nursing Elites

1. The nurse is assessing a newborn the day after birth. A high-pitched cry, irritability, and lack of interest in feeding are noted. The mother signed her own discharge against medical advice. What intervention is appropriate nursing care?

• A. Reduce the environmental stimuli
• B. Offer formula every 2 hours
• C. Talk to the newborn while feeding
• D. Rock the baby frequently

Correct answer: A

Rationale: The correct intervention is to reduce the environmental stimuli. In this scenario, the newborn is displaying signs of overstimulation and distress, which can be exacerbated by environmental factors. Offering formula every 2 hours (Choice B) may not address the underlying issue of overstimulation. Talking to the newborn while feeding (Choice C) and rocking the baby frequently (Choice D) may further stimulate the newborn, which is not appropriate in this case.

2. When a nurse from the surgical department is reassigned to the pediatric unit, the charge nurse should recognize that the child at highest risk for cardiac arrest and is the least likely to be assigned to this nurse is which child?

• A. Congenital cardiac defects
• B. An acute febrile illness
• C. Prolonged hypoxemia
• D. Severe multiple trauma

Correct answer: C

Rationale: The correct answer is C, 'Prolonged hypoxemia.' Prolonged hypoxemia is a critical condition that requires specialized pediatric care due to the high risk of cardiac arrest. The other choices, such as congenital cardiac defects, acute febrile illness, and severe multiple trauma, may also require attention, but prolonged hypoxemia poses the highest risk for cardiac arrest and demands specialized expertise in managing pediatric patients with this condition.

3. When caring for premature newborns in an intensive care setting, a nurse carefully monitors oxygen concentration. What is the most common complication of this therapy?

• A. Intraventricular hemorrhage
• B. Retinopathy of prematurity
• C. Bronchopulmonary dysplasia
• D. Necrotizing enterocolitis

Correct answer: B

Rationale: Retinopathy of prematurity is the most common complication in premature infants exposed to high concentrations of oxygen. This condition leads to abnormal blood vessel growth in the retina, which can potentially result in blindness if not managed promptly. Intraventricular hemorrhage, though a significant concern in premature infants, is not directly related to oxygen therapy. Bronchopulmonary dysplasia is primarily associated with mechanical ventilation and oxygen exposure over time, not specifically with oxygen concentration monitoring. Necrotizing enterocolitis is more linked to gastrointestinal issues and is not the most common complication of oxygen therapy in premature newborns.

4. A newborn presents with a pronounced cephalic hematoma following a birth in the posterior position. Which nursing diagnosis should guide the plan of care?

• A. Pain related to periosteal injury
• B. Impaired mobility related to bleeding
• C. Parental anxiety related to knowledge deficit
• D. Injury related to intracranial hemorrhage

Correct answer: C

Rationale: The correct nursing diagnosis to guide the plan of care for a newborn with a pronounced cephalic hematoma following a birth in the posterior position is 'Parental anxiety related to knowledge deficit.' This is appropriate because the parents may be worried about the appearance and potential complications of the cephalic hematoma. They may require education and reassurance from the nurse. Choices A, B, and D are incorrect because they do not address the emotional needs of the parents and the knowledge deficit they may have regarding the condition.

5. Which of the following statements about breastfeeding is correct?

• A. Breastfeeding within 30 minutes after birth can stimulate breastmilk production
• B. Breastmilk should be started 24 hours after delivery
• C. Breastmilk given exclusively for the first 4 to 6 months of life helps avoid introduction of infection
• D. Breastfeeding should be done as often as the baby wants

Correct answer: C

Rationale: The correct statement about breastfeeding is that breastmilk given exclusively for the first 4 to 6 months of life helps avoid the introduction of infection. This practice is recommended by health experts for optimal infant health. Choice A is incorrect because breastfeeding should ideally start within the first hour after birth to stimulate breastmilk production. Choice B is incorrect because breastmilk should be initiated as soon as possible after delivery, not after 24 hours. Choice D is incorrect because while feeding on demand is generally encouraged, it should also follow a schedule to ensure adequate nutrition and growth for the baby.

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