Nursing Elites

1. What term describes the invagination of one segment of bowel within another?

• A. Atresia
• B. Stenosis
• C. Herniation
• D. Intussusception

Correct answer: D

Rationale: Intussusception is the correct answer. It refers to the condition where one segment of the bowel folds into another, leading to an obstruction. Atresia (Choice A) is the absence or abnormal closure of a normal opening or tubular structure. Stenosis (Choice B) is the narrowing of a passage in the body. Herniation (Choice C) is the abnormal protrusion of an organ or tissue through a defect in its surrounding walls. Intussusception is a medical emergency commonly observed in infants and young children and necessitates prompt intervention to prevent severe complications.

2. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

3. 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.

4. The nurse is presenting a staff development program about understanding culture in the healthcare encounter. Which components should the nurse include in the program? (Select all that apply.)

• A. Cultural humility
• B. All are applicable
• C. Cultural sensitivity
• D. Cultural competency

Correct answer: B

Rationale: Cultural humility, sensitivity, and competency are key components in providing culturally competent care in healthcare encounters.

5. Prior to giving a hospitalized pre-schooler an injection, the nurse gives the child’s teddy bear a “shot” first. This method is known as:

• A. Critical play
• B. Role play
• C. Diversionary activity
• D. Dramatic play

Correct answer: D

Rationale: The correct answer is D: Dramatic play. Dramatic play involves children acting out experiences to better understand them and reduce fear. In this scenario, by giving the teddy bear a 'shot' first, the nurse is engaging in dramatic play to help the child comprehend and feel more comfortable with the upcoming injection.\n A: Critical play involves critical thinking and problem-solving, not acting out scenarios.\n B: Role play typically involves pretending to be someone else, not necessarily acting out a specific experience.\n C: Diversionary activity aims to distract or redirect attention, which is different from the purpose of dramatic play in this context.

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