Nursing Elites

1. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

• A. Position the newborn in a semi-Fowler position.
• B. Allow the newborn to stay in the nursery for observation.
• C. Offer the newborn pacifier for comfort.
• D. Wrap the newborn in blankets and place in an incubator.

Correct answer: A

Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.

2. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

3. Which level nursery classifications are housed in institutions that can provide on-site surgical repair of serious congenital or acquired malformations?

• A. Level III
• B. Level I
• C. Level IV
• D. Level II

Correct answer: C

Rationale: The correct answer is C: Level IV. Level IV nurseries are equipped to provide the highest level of care, including complex surgical interventions for serious congenital or acquired malformations. These nurseries have the necessary resources and expertise to manage critical cases effectively. Choice A: Level III nurseries provide advanced care for moderately ill newborns but may not have the capacity for on-site surgical repair of serious malformations. Choice B: Level I nurseries offer basic care for healthy newborns and those with minor issues, lacking the resources for surgical interventions. Choice D: Level II nurseries can manage moderately ill newborns but may not have the capability for complex surgical interventions like Level IV nurseries.

4. Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa (Sinemet) for newly diagnosed Parkinson�s disease?

• A. Take medication on a full stomach
• B. Change positions slowly
• C. The drug may cause the urine to be very dilute
• D. Carbidopa has many adverse effects

Correct answer: B

Rationale: Postural hypotension is common early in treatment, so the patient should be instructed to change positions slowly. Administration with meals should be avoided, if possible, because food delays the absorption of the levodopa component. If the patient is experiencing side effects of nausea and vomiting, administration with food may be considered. The levodopa component may darken urine. Carbidopa has no adverse effects of its own.

5. When caring for an infant with respiratory syncytial virus (RSV), which of the following actions should the nurse take?

• A. Administer antibiotics IM once per day.
• B. Initiate droplet precautions.
• C. Place the infant in a negative-pressure isolation room.
• D. Suction the nasopharynx as needed.

Correct answer: D

Rationale: When caring for an infant with respiratory syncytial virus (RSV), maintaining a patent airway is crucial. Suctioning the nasopharynx as needed helps clear secretions, prevent airway obstruction, and promote effective breathing. This intervention can aid in improving the infant's respiratory status and overall comfort. Administering antibiotics IM once per day (Choice A) is not indicated for RSV as it is caused by a virus, not bacteria. Initiating droplet precautions (Choice B) is important to prevent the spread of respiratory infections like RSV, but directly caring for the infant involves more specific interventions. Placing the infant in a negative-pressure isolation room (Choice C) is generally reserved for airborne infections, not RSV which spreads through respiratory droplets.

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