Nursing Elites

1. The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurse's intervention include?

• A. Explain the disorder so they can explain it to others.
• B. Help parents understand that this is a minor problem.
• C. Suggest that parents avoid family and friends until the gender is assigned.
• D. Encourage parents not to worry while the tests are being done.

Correct answer: A

Rationale: It is important for the nurse to provide the parents with accurate information so they can confidently explain the situation to others, helping to reduce stress and misinformation. Avoiding family and friends or minimizing the problem is not helpful.

2. The parent asks when the soft area in the infant's head will go away. What is the best response by the nurse?

• A. The area is called the anterior fontanel (fontanelle) and typically closes anytime up to 18 months of age.
• B. The area is called a fontanel (fontanelle). They remain open to allow for rapid brain growth in the first months of life.
• C. The soft spots may stay open until your infant is 2 or 3 years old.
• D. Soft spots on the infant's head should have closed by now.

Correct answer: A

Rationale: The best response by the nurse is A, as the anterior fontanel typically closes between 12-18 months of age, allowing for brain growth during infancy. Choice B is incorrect because it does not provide a specific timeframe for the closure of the fontanel. Choice C is incorrect as it suggests a later closure timeframe than usual. Choice D is incorrect as it states that the soft spots should have closed already, which is inaccurate for a 6-month-old infant.

3. What is the recommended method to assess hydration status in infants?

• A. Capillary refill time
• B. Skin turgor
• C. Urine output
• D. Mucous membranes

Correct answer: C

Rationale: The correct answer is C: Urine output. Assessing urine output is a recommended method to determine hydration status in infants. Adequate urine output indicates good hydration, while decreased urine output may suggest dehydration. Capillary refill time (Choice A) is more indicative of circulatory status rather than hydration. Skin turgor (Choice B) is a useful assessment in adults but can be less reliable in infants. Checking mucous membranes (Choice D) can provide some information on hydration, but it is not as reliable as assessing urine output in infants.

4. Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?

• A. Meperidine (Demerol)
• B. Morphine
• C. Acetaminophen (Tylenol)
• D. Ibuprofen (Motrin)

Correct answer: B

Rationale: In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.

5. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?

• A. The average age of the nurses on the unit
• B. The salary ranges for the nurses on the unit
• C. The education and certification of the nurses on the unit
• D. The number of nurses who have applied but were not hired for the unit

Correct answer: C

Rationale: The education and certification of nurses are key nursing-sensitive indicators that reflect the quality of care provided on the unit.

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