Nursing Elites

1. When taking a child’s blood pressure, what percentage of the upper arm should the nurse ensure the cuff bladder width covers?

• A. 20%
• B. 40%
• C. 60%
• D. 80%

Correct answer: B

Rationale: When taking a child's blood pressure, the nurse should select a cuff with a bladder width that covers 40% of the arm circumference at the midpoint of the upper arm. This ensures accurate readings. Choosing a cuff that covers less or more than 40% can lead to incorrect blood pressure measurements. Therefore, options A, C, and D are incorrect.

2. What term is appropriate terminology to use for an infant whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?

• A. Postterm
• B. Postmature
• C. Low birth weight
• D. Small for gestational age

Correct answer: D

Rationale: The correct answer is D, 'Small for gestational age.' A small for gestational age, or small-for-date, infant is any child whose intrauterine growth rate was slowed and whose birth weight falls below the 10th percentile on intrauterine growth curves. Choices A and B, 'Postterm' and 'Postmature,' refer to infants born after 42 weeks of gestational age regardless of birth weight, and do not specifically address growth rate. Choice C, 'Low birth weight,' refers to infants with a birth weight less than 2500 g (5.5 pounds) regardless of gestational age, which is a different classification compared to being small for gestational age.

3. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

• A. Prevent the spread of infection.
• B. Monitor electrolyte balance.
• C. Prevent abdominal distention.
• D. Maintain accurate records of output.

Correct answer: C

Rationale: The primary purpose of an NG tube post-surgery for Hirschsprung disease is to prevent abdominal distention by decompressing the stomach and intestines. This helps prevent complications and promotes healing.

4. The nurse is using a bulb syringe to suction a neonate after delivery. What is an important consideration?

• A. Compress the bulb before insertion.
• B. Clear the mouth and pharynx before the nasal passages.
• C. Use two bulb syringes, one for the mouth and pharynx and one for the nasal passages.
• D. Continue using a bulb syringe until secretions are removed as mechanical suction is contraindicated.

Correct answer: B

Rationale: The correct consideration when using a bulb syringe to suction a neonate after delivery is to clear the mouth and pharynx before the nasal passages to prevent aspiration of amniotic fluid. Compressing the bulb syringe before insertion is important to create suction. Using two bulb syringes is unnecessary, as one is sufficient for both the mouth/pharynx and nasal passages. It is not recommended to continue using a bulb syringe until all secretions are removed; instead, mechanical suction can be employed if more forceful removal of secretions is required.

5. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

• A. The hepatitis B vaccination series should be begun at birth
• B. All are applicable
• C. Any child not vaccinated at birth should receive two doses at least 4 months apart
• D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

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