Nursing Elites

1. The nurse is caring for an infant after a cleft lip repair. Which of these measures should be included in the plan of care?

• A. Position prone
• B. Provide fluids from a cup
• C. Position supine
• D. Avoid elbow restraints

Correct answer: C

Rationale: The correct measure that should be included in the plan of care for an infant after a cleft lip repair is to position the infant supine. Placing the infant in a supine position helps protect the surgical site from injury and promotes proper healing. Choice A, 'Position prone,' is incorrect as placing the infant prone can put pressure on the surgical site and hinder healing. Choice B, 'Provide fluids from a cup,' is not directly related to the surgical care of a cleft lip repair. Choice D, 'Avoid elbow restraints,' is not specific to the postoperative care of a cleft lip repair.

2. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

• A. Prevent the spread of infection.
• B. Monitor electrolyte balance.
• C. Prevent abdominal distention.
• D. Maintain accurate records of output.

Correct answer: C

Rationale: The primary purpose of an NG tube post-surgery for Hirschsprung disease is to prevent abdominal distention by decompressing the stomach and intestines. This helps prevent complications and promotes healing.

3. Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?

• A. Blended
• B. Nuclear
• C. Extended
• D. Binuclear

Correct answer: C

Rationale: An extended family includes relatives such as grandparents, aunts, uncles, and other extended family members living together, beyond just the nuclear family unit.

4. Physiologically, the child compensates for fluid volume losses by which mechanism?

• A. Inhibition of aldosterone secretion
• B. Hemoconcentration to reduce cardiac workload
• C. Fluid shift from interstitial space to intravascular space
• D. Vasodilation of peripheral arterioles to increase perfusion

Correct answer: C

Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.

5. A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

• A. Propranolol (Inderal)
• B. Calcium gluconate
• C. Mannitol (Osmitrol) or furosemide (Lasix)
• D. Sodium, chloride, and potassium

Correct answer: C

Rationale: Mannitol and furosemide are diuretics commonly used to induce diuresis in acute renal failure, helping to provoke urine flow and manage fluid overload. Calcium gluconate and electrolyte supplementation are used for other specific conditions and not primarily for diuresis.

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