Nursing Elites

1. Which intervention is the most appropriate recommendation for relief of teething pain?

• A. Rub gums with aspirin to relieve inflammation
• B. Apply hydrogen peroxide to gums to relieve irritation
• C. Give the infant a frozen teething ring to relieve inflammation
• D. Have the infant chew on a warm teething ring to encourage tooth eruption

Correct answer: C

Rationale: A frozen teething ring is effective for relieving teething pain as the cold helps numb the gums and reduce inflammation, making it a safe and effective method for managing discomfort

2. The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe?

• A. Spitting up
• B. Bilious vomiting
• C. Failure to thrive
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, as gastroesophageal reflux disease (GERD) in infants typically presents with symptoms such as spitting up, failure to thrive, excessive crying, and respiratory problems due to aspiration. Bilious vomiting is not a common symptom of GERD in infants and may indicate a different or more severe condition, such as intestinal obstruction or other gastrointestinal issues. Therefore, choices A, B, and C are all expected clinical manifestations of GERD in a 6-month-old child, making option D the correct answer.

3. In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?

• A. Limit fluids to reduce reflux.
• B. Give cranberry juice twice a day.
• C. Have siblings examined for VUR.
• D. Surgery is indicated to reverse scarring.

Correct answer: C

Rationale: Siblings should be examined for VUR as it can run in families, and early detection can prevent complications. Limiting fluids is not advisable, and cranberry juice is not effective in preventing VUR. Surgery is usually not indicated for scarring reversal.

4. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?

• A. A low-fiber diet is not always required.
• B. Stress management may be helpful.
• C. Milk products may or may not be a contributing factor.
• D. Pantoprazole (a proton pump inhibitor) is not a first-line treatment.

Correct answer: B

Rationale: The correct answer is B: Stress management may be helpful. Stress is known to exacerbate symptoms of irritable bowel syndrome (IBS), making stress management an essential part of managing the condition. While dietary modifications can also be beneficial, a low-fiber diet is not universally recommended for IBS, as fiber can be important for some individuals. Milk products may or may not be contributing factors, as food triggers can vary among individuals. Pantoprazole, a proton pump inhibitor, is not typically the first-line treatment for IBS, as it is more commonly used for conditions like gastroesophageal reflux disease.

5. Melena, the passage of black, tarry stools, suggests bleeding from which source?

• A. The perianal or rectal area
• B. The upper gastrointestinal (GI) tract
• C. The lower GI tract
• D. Hemorrhoids or anal fissures

Correct answer: B

Rationale: Melena indicates bleeding from the upper GI tract. The black, tarry appearance of the stool results from the partial digestion of blood as it passes through the intestines, typically originating from sources like the stomach or duodenum. Lower GI bleeding usually presents as bright red blood in the stool, originating from sources like the colon or rectum. Choices A, C, and D are incorrect because melena specifically points to upper GI bleeding rather than issues in the perianal/rectal area, lower GI tract, or hemorrhoids/anal fissures.

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