Nursing Elites

1. What is an approximate method of estimating output for a child who is not toilet trained?

• A. Have parents estimate output.
• B. Weigh diapers after each void.
• C. Place a urine collection device on the child.
• D. Have the child sit on a potty chair 30 minutes after eating.

Correct answer: B

Rationale: Weighing diapers is the most accurate way to estimate urine output in a child who is not toilet trained. This method provides a measurable and reliable estimate of fluid output.

2. A child is admitted with suspected pyloric stenosis. Which of the following should be included in the plan of care?

• A. Monitor for signs of metabolic acidosis
• B. Observe for projectile vomiting
• C. Provide large, infrequent feedings to allow for rest
• D. Place the infant in a supine position after feeding

Correct answer: B

Rationale: The correct answer is B: 'Observe for projectile vomiting.' Projectile vomiting is a classic sign of pyloric stenosis, caused by obstruction at the pylorus. Choice A is incorrect as metabolic alkalosis, not acidosis, often occurs due to the loss of hydrochloric acid from persistent vomiting. Choice C is incorrect as frequent, small feedings are preferred to prevent overloading the stomach. Choice D is incorrect as placing the infant in an upright position after feeding can help reduce reflux.

3. What should the healthcare provider consider when providing support to a family whose infant has just been diagnosed with biliary atresia?

• A. The prognosis for full recovery is excellent.
• B. Death usually occurs by 6 months of age.
• C. Liver transplantation may be needed eventually.
• D. Children with surgical correction live normal lives.

Correct answer: C

Rationale: When supporting a family whose infant has been diagnosed with biliary atresia, it is important to consider that liver transplantation may be needed eventually. Biliary atresia is a serious condition where bile flow from the liver to the gallbladder is blocked or absent. While surgical interventions like the Kasai procedure can temporarily improve bile flow and delay the need for transplantation, the long-term survival often depends on liver transplantation as the child grows older. Choices A, B, and D are incorrect because the prognosis for full recovery is not excellent as biliary atresia is a chronic condition that often requires ongoing medical management, death usually does not occur by 6 months of age but the condition does require intervention, and not all children with surgical correction can live normal lives without the need for further interventions like transplantation.

4. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?

• A. Initiate a game of peek-a-boo.
• B. Ask the infant's father to place the infant on the examination table
• C. Talk softly to the infant while taking him from his father
• D. Undress the infant while he is still sitting on his father’s lap

Correct answer: A

Rationale: Engaging the infant in a familiar game like peek-a-boo can help reduce fear and build rapport before starting the assessment.

5. What are classified as hydrocarbon poisons?

• A. All below
• B. Gasoline
• C. Turpentine
• D. Lighter fluid

Correct answer: A

Rationale: Hydrocarbon poisons include substances like gasoline, turpentine, and lighter fluid, which are typically liquids derived from petroleum. Bleach is a corrosive substance, not a hydrocarbon.

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