Nursing Elites

1. The healthcare provider is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?

• A. Vital signs and neurologic checks hourly
• B. Small, frequent formula feedings
• C. Elevate the head of the bed
• D. Daily head circumference measurements

Correct answer: C

Rationale: Elevating the head of the bed in a child with hydrocephalus can potentially increase intracranial pressure. This can be counterproductive and may lead to complications after shunt placement surgery. Keeping the head of the bed flat or slightly elevated is often recommended to optimize cerebral perfusion and reduce the risk of increased intracranial pressure.

2. While auscultating the lungs of an adolescent with asthma, what should the nurse identify the sound as?

• A. Biots respiration
• B. Chaney-Stokes respiration
• C. Tachypnea
• D. Bradypnea

Correct answer: C

Rationale: The nurse should identify the sound heard during auscultation as tachypnea, which is characterized by a rapid, regular breathing pattern. In the case of an adolescent with asthma, tachypnea can be indicative of increased work of breathing due to airway constriction and inflammation. Biots respiration (choice A) is characterized by an irregular pattern of breathing with periods of apnea. Chaney-Stokes respiration (choice B) is a pattern of breathing characterized by alternating periods of deep, rapid breathing followed by periods of apnea. Bradypnea (choice D) refers to an abnormally slow breathing rate, which is not typically associated with asthma exacerbation.

3. What is the last step in interpersonal reasoning?

• A. Choose a response or mode sequence
• B. Gather Feedback
• C. Anticipate
• D. Determine if a mode shift is required

Correct answer: B

Rationale: The last step in interpersonal reasoning involves gathering feedback. Once you have gone through the process of anticipating, choosing a response or mode sequence, and determining if a mode shift is required, the final step is to gather feedback to assess the effectiveness of your interaction and make any necessary adjustments.

4. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?

• A. 3 months
• B. 2 weeks
• C. 2.6 months
• D. 4 weeks

Correct answer: B

Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.

5. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?

• A. The dialysate is clear upon return.
• B. The volume of drained dialysate is less than the volume infused.
• C. The child is restless and eager to play.
• D. The child's vital signs remain consistent with those noted during infusion.

Correct answer: B

Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.

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