Nursing Elites

1. What should the nurse include in the discharge instructions for the parents of an infant diagnosed with acute otitis media?

• A. Keep the baby in an elevated position during sleep
• B. Administer an antibiotic
• C. Place the baby to sleep with a bottle
• D. Administer acetaminophen (Tylenol) to relieve discomfort

Correct answer: D

Rationale: Acetaminophen (Tylenol) is recommended to help relieve the discomfort associated with acute otitis media, such as pain and fever. Elevating the baby's head during sleep can also help with drainage and relieve pressure, making choice A incorrect. Administering an antibiotic may be necessary for bacterial otitis media but is not usually the first-line treatment for acute otitis media, so choice B is incorrect. Placing the baby to sleep with a bottle can increase the risk of ear infections due to the pooling of milk around the Eustachian tube, so choice C is incorrect.

2. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children?

• A. Foster children always come from abusive households and are emotionally fragile.
• B. Foster children tend to have a higher than normal incidence of acute and chronic health problems.
• C. Foster children are usually born prematurely and require technologically advanced health care.
• D. Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment.

Correct answer: B

Rationale: Foster children often have higher rates of acute and chronic health problems due to a variety of factors, including previous neglect, trauma, and inconsistent healthcare access.

3. A child diagnosed with aplastic anemia is admitted to the hospital. The parents ask the nurse what aplastic anemia is. Which response by the nurse is accurate?

• A. Aplastic anemia causes a proliferation of white blood cells.
• B. Aplastic anemia is characterized by abnormally shaped red blood cells.
• C. Aplastic anemia is caused by the bone marrow producing inadequate cells.
• D. Aplastic anemia is a disorder that occurs after a viral illness.

Correct answer: C

Rationale: Aplastic anemia is a condition where the bone marrow fails to produce sufficient red blood cells, white blood cells, and platelets, leading to pancytopenia. This can result in fatigue, infections, and bleeding tendencies. It is not characterized by abnormal red blood cell shapes, but rather by a reduction in the production of blood cells. Therefore, the accurate response is that aplastic anemia is caused by the bone marrow producing inadequate cells. Choices A and B are incorrect as aplastic anemia does not cause a proliferation of white blood cells or involve abnormally shaped red blood cells. Choice D is incorrect as aplastic anemia is not typically a disorder that occurs after a viral illness.

4. Which distraction technique should be used for an adolescent child during a painful procedure?

• A. Blowing bubbles
• B. Guided imagery
• C. EMLA cream
• D. Sucrose solution

Correct answer: B

Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.

5. A young mother asks if her 9-month-old can begin drinking cow’s milk instead of formula. You explain that:

• A. Cow’s milk is easier to digest than formula
• B. Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year
• C. As long as whole milk is given and not skim milk, it is okay
• D. Cow’s milk will decrease the chance of iron deficiency anemia

Correct answer: B

Rationale: Breast milk or formula should be used for now because whole cow’s milk is not recommended for infants under 1 year. Cow’s milk is not suitable for infants under 1 year of age as it lacks essential nutrients like iron and can lead to iron deficiency. Therefore, it is important to continue with breast milk or formula to ensure the baby's nutritional needs are met. Choice A is incorrect as cow’s milk is not easier to digest than formula for infants. Choice C is incorrect as the type of milk, whether whole or skim, is not the primary concern at this age. Choice D is incorrect as cow’s milk can actually increase the risk of iron deficiency anemia in infants.

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