Nursing Elites

1. The healthcare provider is caring for a newborn who is 2 days old. Which finding should be reported to the healthcare provider?

• A. Yellowing of the skin
• B. Presence of a small amount of blood in the diaper
• C. Peeling skin on the hands and feet
• D. Intermittent episodes of sneezing

Correct answer: A

Rationale: Yellowing of the skin may indicate jaundice in a newborn, which can be a sign of an underlying health issue such as an elevated bilirubin level. It is essential to report this finding to the healthcare provider for further assessment and appropriate management to prevent complications.

2. A breastfeeding mother reports breast engorgement. The nurse advises her to:

• A. Increase the frequency of feedings
• B. Apply ice packs to the breasts
• C. Avoid breastfeeding until the pain subsides
• D. Use a breast pump to empty the breasts completely

Correct answer: A

Rationale: Breast engorgement occurs when the breasts become overfilled with milk. By increasing the frequency of feedings, the mother can ensure that her breasts are emptied regularly, helping to relieve the discomfort associated with engorgement. This advice promotes effective milk removal and prevents further accumulation, which can worsen the condition. Applying ice packs may provide temporary relief, but it does not address the underlying issue of milk accumulation. Avoiding breastfeeding can lead to further engorgement and potential complications. Using a breast pump to empty the breasts completely may be necessary in some cases, but increasing the frequency of feedings is the initial and most appropriate intervention to manage breast engorgement.

3. What is the most important intervention to decrease the stressors of hospitalization for a 9-month-old infant being treated for a bacterial infection?

• A. Encourage the infant's parents to remain at the bedside and actively participate in the infant's care.
• B. Provide a brightly lit environment for the infant.
• C. Play tapes of the mother's voice.
• D. Assign the same nurse to the infant as much as possible.

Correct answer: A

Rationale: Encouraging the infant's parents to remain at the bedside and actively participate in the infant's care is crucial in decreasing the stressors of hospitalization for the infant. Parental presence provides comfort and security, promotes bonding, and maintains a sense of familiarity for the infant during a potentially stressful situation. This involvement can help reduce anxiety and promote better outcomes for the infant's emotional well-being and overall hospital experience. Providing a brightly lit environment (choice B) can actually increase stress for the infant, as infants generally prefer dimly lit environments for better sleep. Playing tapes of the mother's voice (choice C) may offer some comfort but does not substitute for parental presence. While assigning the same nurse to the infant (choice D) can provide continuity of care, it is not as effective as having the parents present for emotional support and bonding.

4. A 3-year-old boy is found to be in cardiopulmonary arrest. As you begin one-rescuer CPR, your partner prepares the AED. What is the appropriate compression to ventilation ratio for this child?

• A. 3:01
• B. 30:2
• C. 15:2
• D. 5:1

Correct answer: B

Rationale: The correct compression to ventilation ratio for a single rescuer performing CPR on a child is 30:2. This ratio ensures adequate circulation and oxygenation during CPR. 30 compressions help maintain blood flow, while 2 rescue breaths provide oxygenation. Choice A (3:01) is incorrect as it does not follow the standard CPR guidelines for children. Choice C (15:2) is incorrect as it is the ratio used for adult CPR. Choice D (5:1) is incorrect as it is not the recommended ratio for child CPR.

5. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares with the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following?

• A. The child should be allowed to play because doing so can foster healthy self-esteem
• B. The risk for fractures is increased because GH deficiency results in fragile bones
• C. Activity could aggravate insulin sensitivity, causing hyperglycemia
• D. Activity would aggravate the child's joints, already overtasked by obesity

Correct answer: A

Rationale: Children with GH deficiency may face challenges due to their size, but it is important to encourage their participation in activities like playing ball games to promote healthy self-esteem. Allowing the child to play can help in building confidence and a sense of accomplishment, which are essential for their overall well-being.

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