Nursing Elites

1. What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?

• A. Teaching how to irrigate the colostomy
• B. Protecting the skin around the colostomy
• C. Discussing the implications of a colostomy during puberty
• D. Using simple, straightforward language to prepare the child

Correct answer: B

Rationale: Protecting the skin around the colostomy is crucial to prevent irritation and infection, which are common complications in infants with colostomies. Teaching and discussing long-term implications are important but secondary to immediate skin care needs.

2. What intervention is crucial during a sickle cell crisis in a child?

• A. Administer oxygen
• B. Apply cold compresses
• C. Restrict fluids
• D. Encourage bed rest

Correct answer: A

Rationale: Administering oxygen is crucial during a sickle cell crisis in a child as it helps to prevent further sickling of cells. Oxygen therapy can improve oxygen saturation levels, reducing the risk of tissue damage and complications. Applying cold compresses (choice B) is not recommended as it can potentially worsen vaso-occlusive crisis by causing vasoconstriction. Restricting fluids (choice C) is not appropriate as hydration is essential to prevent dehydration and maintain adequate blood flow. Encouraging bed rest (choice D) may be necessary but administering oxygen takes precedence in managing a sickle cell crisis.

3. The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.)

• A. Advertising of unhealthy food can increase snacking
• B. Increased screen time may be related to unhealthy sleep
• C. There is a link between the amount of screen time and obesity
• D. All of the above

Correct answer: D

Rationale: Increased screen time is associated with unhealthy habits, such as poor sleep and snacking, which contribute to obesity, but it does not necessarily improve nutrition knowledge.

4. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?

• A. Interactional theory
• B. Family stress theory
• C. Erikson's psychosocial theory
• D. Developmental systems theory

Correct answer: B

Rationale: Family stress theory explains how families respond to stress and identifies factors that help families adapt to and manage stressful events effectively.

5. The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?

• A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
• B. Hold the infant in the prone position after a feeding.
• C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
• D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.

Correct answer: D

Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.

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