Nursing Elites

1. What is the priority assessment for a nurse when caring for an infant suspected of having necrotizing enterocolitis (NEC)?

• A. Hold feedings.
• B. Check gastric residuals before feedings.
• C. Take rectal temperature.
• D. Closely monitor abdominal distention.

Correct answer: D

Rationale: The correct answer is D: Closely monitor abdominal distention. Monitoring the abdomen for signs of distention is crucial in the early detection of necrotizing enterocolitis (NEC). In NEC, the bowel wall is edematous and breaking down, leading to abdominal distention. Holding feedings is important in the management of NEC, as feedings may need to be stopped temporarily. Checking gastric residuals before feedings helps in assessing the infant's tolerance to feedings. Taking rectal temperatures is contraindicated in NEC as it can lead to the perforation of the bowel.

2. The nurse is aware that if patients from different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?

• A. Acculturation
• B. Ethnocentrism
• C. Cultural shock
• D. Cultural sensitivity

Correct answer: B

Rationale: Ethnocentrism is the belief that one's own culture is superior to others, which can lead to bias and a lack of cultural competence in healthcare.

3. What statement is descriptive of renal transplantation in children?

• A. It is an acceptable means of treatment after age 10 years.
• B. Children can receive kidneys only from other children.
• C. It is the preferred means of renal replacement therapy in children.
• D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Correct answer: C

Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.

4. What is characteristic of a neonate’s vision?

• A. Pupils react to light
• B. Tear glands function
• C. Blink reflex is absent
• D. Ciliary muscles are mature

Correct answer: A

Rationale: The correct answer is A: 'Pupils react to light.' Newborns' pupils do react to light, indicating that the visual pathway is functioning. However, a neonate's vision is still developing, and they can only focus on objects close to their face. Choice B is incorrect because tear glands are functional at birth. Choice C is incorrect because the blink reflex is present in neonates and helps protect their eyes. Choice D is incorrect as neonates' ciliary muscles are not fully developed.

5. A young mother asks if her 9-month-old can begin drinking cow’s milk instead of formula. You explain that:

• A. Cow’s milk is easier to digest than formula
• B. Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year
• C. As long as whole milk is given and not skim milk, it is okay
• D. Cow’s milk will decrease the chance of iron deficiency anemia

Correct answer: B

Rationale: Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year. Cow’s milk is not suitable for infants under 1 year of age as it lacks essential nutrients like iron and can lead to iron deficiency. Therefore, it is important to continue with breast milk or formula to ensure the baby's nutritional needs are met. Choice A is incorrect as cow’s milk is not easier to digest than formula for infants. Choice C is incorrect as the type of milk, whether whole or skim, is not the primary concern at this age. Choice D is incorrect as cow’s milk can actually increase the risk of iron deficiency anemia in infants.

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