Nursing Elites

1. What is a primary consideration for complications when planning nursing care for an infant with Meconium aspiration syndrome?

• A. Hypoglycemia
• B. Bowel obstruction
• C. Airway obstruction
• D. Carbon dioxide retention

Correct answer: C

Rationale: The correct answer is C: Airway obstruction. When planning nursing care for an infant with Meconium aspiration syndrome, a primary consideration for complications is the potential of airway obstruction. After the passage of meconium into the amniotic fluid, the infant may inhale or swallow the fluid, leading to meconium aspiration into the lower airways and causing a partial airway obstruction. This can result in respiratory distress and hypoxemia. Hypoglycemia (choice A) is a metabolic condition unrelated to meconium aspiration. Bowel obstruction (choice B) with meconium may indicate other conditions like cystic fibrosis or Hirschsprung disease, not directly related to meconium aspiration syndrome. Carbon dioxide retention (choice D) is not a primary consideration in meconium aspiration syndrome; instead, the focus is on addressing the airway obstruction and potential respiratory compromise.

2. Pertussis vaccination should begin at which age?

• A. Birth
• B. 2 months
• C. 6 months
• D. 12 months

Correct answer: B

Rationale: The DTaP vaccine, which includes pertussis, is typically started at 2 months of age as part of the recommended immunization schedule.

3. What is the primary treatment for Kawasaki disease?

• A. Corticosteroids
• B. Intravenous immunoglobulin
• C. Antibiotics
• D. Antivirals

Correct answer: B

Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.

4. The nurse is teaching parents about diarrhea in young children. A parent asks the nurse what causes most cases of diarrhea in young children. How should the nurse respond?

• A. Rotavirus
• B. Giardia
• C. Shigella
• D. Salmonella

Correct answer: A

Rationale: Rotavirus is the most common cause of diarrhea in young children, particularly those under the age of 2. Giardia, Shigella, and Salmonella can also cause diarrhea, but in the context of young children, Rotavirus is the primary pathogen responsible for diarrheal illnesses.

5. When should a child receive the first dose of the hepatitis B virus (HBV) vaccine if the mother is hepatitis B surface antigen (HBsAg) negative?

• A. 2 months of age, before hospital discharge.
• B. Birth before discharge from the hospital.
• C. 6 months of age, at the third well-child visit.
• D. No time (this vaccine is not currently recommended).

Correct answer: B

Rationale: If the mother is HBsAg negative, it is recommended that the child receives the first dose of the hepatitis B vaccine at birth before discharge from the hospital. This is to provide early protection against the hepatitis B virus. The second dose of the vaccine is typically given at the first well-child visit, and the third dose is usually administered at a later date. The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Committee on Infectious Diseases of the American Academy of Pediatrics govern the recommendations for immunization, including the hepatitis B virus vaccine. Choice A is incorrect as the first dose should ideally be given at birth. Choice C is incorrect as waiting until 6 months of age may leave the child vulnerable to infection during the early months of life. Choice D is incorrect as the hepatitis B vaccine is recommended for all newborns, especially if the mother is HBsAg negative, to prevent transmission of the virus.

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