Nursing Elites

1. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)

• A. Lightly brush the palate with a cotton swab
• B. Perform the examination in front of a mirror
• C. Let the child examine someone else's mouth first
• D. All of the above

Correct answer: D

Rationale: Using a cotton swab, allowing the child to observe, and demonstrating on someone else are effective ways to encourage a preschooler to open their mouth for examination.

2. What should the healthcare provider consider when providing support to a family whose infant has just been diagnosed with biliary atresia?

• A. The prognosis for full recovery is excellent.
• B. Death usually occurs by 6 months of age.
• C. Liver transplantation may be needed eventually.
• D. Children with surgical correction live normal lives.

Correct answer: C

Rationale: When supporting a family whose infant has been diagnosed with biliary atresia, it is important to consider that liver transplantation may be needed eventually. Biliary atresia is a serious condition where bile flow from the liver to the gallbladder is blocked or absent. While surgical interventions like the Kasai procedure can temporarily improve bile flow and delay the need for transplantation, the long-term survival often depends on liver transplantation as the child grows older. Choices A, B, and D are incorrect because the prognosis for full recovery is not excellent as biliary atresia is a chronic condition that often requires ongoing medical management, death usually does not occur by 6 months of age but the condition does require intervention, and not all children with surgical correction can live normal lives without the need for further interventions like transplantation.

3. What interventions should be implemented to maintain the skin integrity of a preterm infant born at 30 weeks?

• A. Avoid cleaning the skin
• B. Bathe the infant with sterile water
• C. Cleanse the skin with a gentle alkaline-based soap and water
• D. Thoroughly rinse the skin with plain water after bathing

Correct answer: B

Rationale: The correct intervention to maintain the skin integrity of a preterm infant born at 30 weeks is to bathe the infant with sterile water. Bathing with sterile water or a neutral pH solution is recommended to protect the delicate skin of preterm infants, which is more permeable and prone to damage. Choices A, C, and D are incorrect as avoiding cleaning the skin may lead to hygiene issues, cleansing with alkaline-based soap can be harsh on the delicate skin, and thoroughly rinsing with plain water after bathing may not be as gentle and protective for preterm infants.

4. What is the primary goal in the treatment of a child with nephrotic syndrome?

• A. Decrease urine output
• B. Increase serum albumin
• C. Reduce proteinuria
• D. Increase blood pressure

Correct answer: C

Rationale: The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.

5. During which phase of the nursing process does the nurse use essential information about the child’s physical, social, and emotional health to decide which interventions to use?

• A. Implementation
• B. Planning
• C. Diagnosis
• D. Assessment

Correct answer: B

Rationale: The correct answer is B: Planning. During the planning phase of the nursing process, the nurse utilizes essential information gathered during the assessment about the child’s physical, social, and emotional health to determine the most appropriate interventions to address the identified needs. This phase focuses on developing a comprehensive care plan tailored to the individual child. A) Implementation is incorrect because this phase involves carrying out the interventions outlined in the care plan. C) Diagnosis is incorrect as it refers to identifying health issues based on the assessment data. D) Assessment is incorrect as it involves collecting and analyzing data about the child's health status, rather than deciding on interventions.

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