Nursing Elites

1. When planning care for a newborn with esophageal atresia and tracheoesophageal fistula, which is the priority nursing diagnosis?

• A. Ineffective Tissue Perfusion
• B. Ineffective Infant Feeding Pattern
• C. Acute Pain
• D. Risk for Aspiration

Correct answer: D

Rationale: The priority nursing diagnosis for a newborn with esophageal atresia and tracheoesophageal fistula is 'Risk for Aspiration' because of the potential respiratory complications associated with these conditions. The newborn is at a higher risk of aspirating oral or gastric contents due to the abnormal connections between the esophagus and trachea, posing a serious threat to the airway and lungs. Addressing this risk is crucial to prevent respiratory distress and maintain the airway's patency, making it the priority nursing diagnosis in this scenario. 'Ineffective Tissue Perfusion' is not the priority as respiratory compromise takes precedence over perfusion concerns. 'Ineffective Infant Feeding Pattern' may be relevant but addressing the risk of aspiration is more critical. 'Acute Pain' is not the priority compared to the life-threatening risk of aspiration.

2. The nurse is reviewing the prescriber�s orders and notes that omeprazole has been order for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient�s record.

• A. Aspirin 81mg daily
• B. Clopidogrel (Plavix) 75mg daily
• C. Heparin 5000 units subQ q12hrs
• D. Metoprolol 50mg q8hrs

Correct answer: B

Rationale: For patients who lack risk factors for GI bleeding, combined use of clopidogrel with a PPI, may reduce the effects of clopidogrel without offering any real benefits and thus should be avoided.

3. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?

• A. Impaired Gas Exchange
• B. Risk for Infection
• C. Anxiety (parental)
• D. Acute Pain

Correct answer: A

Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.

4. What type of characteristic is described in this scenario?

• A. Mode Change
• B. Social
• C. Enduring
• D. Situational

Correct answer: D

Rationale: The scenario describes a temporary change in Ava's emotional state due to a specific event - the fight with her friend. This aligns with the definition of a situational characteristic, which is influenced by specific circumstances or events. Ava's sadness and tearfulness in this situation are not reflective of a permanent trait but rather a response to a particular situation. Choices A, B, and C are incorrect. 'Mode Change' does not accurately describe the situation; 'Social' is too broad and does not specifically address Ava's emotional state change; 'Enduring' implies a long-lasting trait, which is not the case in this scenario.

5. A nurse is planning care for a school-age child who has thrombocytopenia. Which of the following interventions should the nurse include in the plan?

• A. Administer aspirin as needed for fever.
• B. Avoid venipunctures whenever possible.
• C. Encourage the child to participate in contact sports.
• D. Administer ibuprofen for pain.

Correct answer: B

Rationale: The correct answer is B: 'Avoid venipunctures whenever possible.' Thrombocytopenia is a condition characterized by a low platelet count, which can lead to an increased risk of bleeding. Venipunctures can cause bleeding in these patients; therefore, they should be avoided whenever possible. Choice A is incorrect because aspirin should be avoided in patients with thrombocytopenia as it can further increase the risk of bleeding due to its antiplatelet effects. Choice C is incorrect because participating in contact sports can also increase the risk of injury and bleeding in a child with thrombocytopenia. Choice D is incorrect as ibuprofen, like aspirin, can also increase the risk of bleeding and should be avoided in these patients.

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