Nursing Elites

1. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.)

• A. Decrease tobacco use
• B. Improve immunization rates
• C. All are applicable
• D. Increase access to health care

Correct answer: C

Rationale: Healthy People 2020 focuses on decreasing tobacco use, improving immunization rates, and increasing access to healthcare among its leading health indicators.

2. The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed?

• A. "We will try to preserve the adopted child's racial heritage."
• B. "We are glad we will be getting full medical information when we adopt our child."
• C. "We will make sure to have everyone realize this is our child and a member of the family."
• D. "We understand strangers may make thoughtless comments about our child being different from us."

Correct answer: C

Rationale: The statement about making sure others realize the child is part of the family may indicate a focus on external validation rather than on the child’s needs and identity, suggesting a need for further teaching.

3. While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?

• A. The 6-month-old in deep sleep
• B. The 2-year-old who is cooperative when the nurse takes vital signs
• C. The 4-year-old who is actively watching cartoons
• D. The 14-month-old who is screaming and thrashing his arms and legs

Correct answer: D

Rationale: The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.

4. The nurse is caring for an infant who was born 24 hr ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include hyperactive reflexes, tremors, sneezing, and a high-pitched shrill cry. What does the nurse consider as a possible diagnosis for this infant?

• A. Seizure disorder
• B. Narcotic withdrawal
• C. Placental insufficiency
• D. Meconium aspiration syndrome

Correct answer: B

Rationale: In this case, the infant's symptoms are consistent with narcotic withdrawal. Infants exposed to drugs in utero may display withdrawal symptoms starting around 12 to 24 hours post-birth. The presentation often includes hyperactive reflexes, tremors, sneezing, high-pitched shrill cry, poor feeding, and sucking avidly on hands. Signs such as loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are common. These symptoms are not indicative of a seizure disorder. Placental insufficiency typically leads to a small-for-gestational-age child, which is not mentioned in the scenario. Meconium aspiration syndrome primarily presents with respiratory distress, not the symptoms described in this case.

5. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

• A. Initiating breast or bottle-feedings to stabilize the blood glucose level
• B. Maintaining pain management with an intravenous opioid
• C. Covering the intact bowel with a nonadherent dressing to prevent injury
• D. Performing immediate surgery

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

Similar Questions