Nursing Elites

1. What test is used to screen for carbohydrate malabsorption?

• A. Stool pH
• B. Urine ketones
• C. C urea breath test
• D. ELISA stool assay

Correct answer: A

Rationale: Stool pH testing is used to screen for carbohydrate malabsorption. A low pH indicates the presence of unabsorbed carbohydrates, which are fermented by bacteria, leading to acidic stool.

2. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care would include what?

• A. Monitor closely for signs of infection.
• B. Place the child with the operative side of the head up.
• C. Avoid pumping the shunt reservoir to maintain patency.
• D. Avoid maintaining a Trendelenburg position to decrease pressure on the shunt.

Correct answer: A

Rationale: Postoperative nursing care for an infant with hydrocephalus who underwent ventriculoperitoneal shunt placement includes monitoring closely for signs of infection, as infection is the greatest hazard in the postoperative period. Signs of cerebrospinal fluid infection to watch for include elevated temperature, poor feeding, vomiting, decreased responsiveness, and seizure activity. The child should be placed with the operative side of the head up to reduce pressure on the valve. The shunt reservoir should not be pumped to maintain patency, as this can disrupt its function. Maintaining a Trendelenburg position to decrease pressure on the shunt is contraindicated as it can lead to increased intracranial pressure and compromise the shunt's effectiveness.

3. An effective means of establishing rapport with the hospitalized pre-schooler is through:

• A. Lengthy discussion
• B. Explanation with drawings and models
• C. Play
• D. Silence

Correct answer: C

Rationale: Play is an effective way to communicate and build rapport with young children, especially pre-schoolers. It helps them feel comfortable, express themselves, and establish a connection with the caregiver. Lengthy discussions may not be suitable for their age and attention span, while explanation with drawings and models can enhance communication but may not engage them as effectively as play. Silence, on the other hand, may create a sense of unease or lack of interaction for pre-schoolers.

4. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?

• A. Antibiotic treatment
• B. Adenoidectomy
• C. The insertion of tympanostomy (pressure equalizing) tubes
• D. Tonsillectomy

Correct answer: C

Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.

5. A child who weighs 10 kg is to receive Motrin 8 mg/kg po q4h prn for pain. The label reads 100 mg/5 mL. How much will you administer?

• A. 4 mL
• B. 2 mL
• C. 5 mL
• D. 3 mL

Correct answer: A

Rationale: To calculate the dosage, multiply the child's weight (10 kg) by the dosage (8 mg/kg) which equals 80 mg. Since the concentration is 100 mg/5 mL, to find out how much to administer, you need to determine how many 5 mL doses are in 80 mg. It will be 80 mg ÷ 100 mg * 5 mL = 4 mL. Therefore, the correct answer is 4 mL. Choice B, 2 mL, is incorrect because it does not account for the correct dosage calculation. Choice C, 5 mL, is incorrect as it does not consider the dosage based on the child's weight. Choice D, 3 mL, is incorrect as it does not reflect the accurate dosage calculation.

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