Nursing Elites

1. Where is the best place to observe for the presence of petechiae in dark-skinned individuals?

• A. Face
• B. Buttocks
• C. Oral mucosa
• D. Palms and soles

Correct answer: C

Rationale: The oral mucosa and conjunctivae are the best places to observe petechiae in dark-skinned individuals because these areas have less pigmentation.

2. What does the American Academy of Pediatrics recommend as the best form of infant nutrition?

• A. Exclusive breastfeeding until 1 year of age
• B. Exclusive breastfeeding until 6 months of age
• C. Commercially prepared infant formula until 1 year of age
• D. Commercially prepared infant formula until 4 to 6 months of age

Correct answer: A

Rationale: The American Academy of Pediatrics advocates for exclusive breastfeeding until 1 year of age as the best form of infant nutrition. Breastfeeding for the first year of life provides optimal nutrition and benefits for the infant. Exclusive breastfeeding until 6 months of age is not in line with the AAP's recommendation for a full year. While commercially prepared infant formula is an alternative if breastfeeding is not possible, it is not the preferred choice according to AAP guidelines. The recommendation for commercial infant formula until 1 year of age is not in line with the AAP's stance on the benefits of extended breastfeeding.

3. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

4. The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching?

• A. Oranges
• B. All are correct
• C. Lima beans
• D. Baked beans

Correct answer: B

Rationale: The correct answer is B: All are correct. High-fiber foods like oranges, lima beans, baked beans, and raisin bran cereal are effective in preventing constipation. Oranges are a good source of fiber, lima beans and baked beans are high in fiber content, and raisin bran cereal is also rich in fiber. Bananas, which are not listed but could be considered by some as a high-fiber food, are actually low in fiber and may not be as effective in preventing constipation. Therefore, the nurse should include all the options provided in the teaching to help prevent constipation effectively.

5. What is the appropriate method for measuring the temperature of a 2-day-old neonate?

• A. Tympanic
• B. Oral
• C. Axillary
• D. Rectal

Correct answer: C

Rationale: For a 2-day-old neonate, the most suitable method to measure temperature is the axillary method. This approach is considered safe and appropriate for neonates, minimizing the risk of injury. Tympanic temperature measurement may not be as accurate in neonates due to their small ear canals. Oral temperature measurement is not recommended for neonates as they may not be able to hold a thermometer properly in their mouths. Rectal temperature measurement is invasive and carries a higher risk of injury and should be avoided unless absolutely necessary.

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