Nursing Elites

1. Which statement regarding bottle mouth caries requires further teaching?

• A. Caries can be decreased by putting an infant to bed with a bottle of milk or sweetened juice
• B. Eliminating the bedtime bottle or substituting water is recommended
• C. Sugar pools within the oral cavity cause severe decay
• D. It is often seen in children between 18 months and 3 years

Correct answer: A

Rationale: The correct answer is A. Putting an infant to bed with a bottle of milk or sweetened juice increases the risk of bottle mouth caries rather than decreasing it. This statement requires further teaching as it provides incorrect information. Choice B is correct as eliminating the bedtime bottle or substituting water is recommended to prevent bottle mouth caries. Choice C is also correct as sugar pooling within the oral cavity can indeed cause severe decay. Choice D is correct as bottle mouth caries is often observed in children between 18 months and 3 years.

2. The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?

• A. Heat only 10 oz or more.
• B. Do not thaw or heat breast milk in a microwave oven.
• C. Always leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Thawing or heating breast milk in a microwave is not recommended because it can create hot spots that may burn the infant and destroy essential nutrients.

3. A 14-month-old child is admitted to the hospital with laryngotracheobronchitis (LTB). Which assessment findings should the nurse expect?

• A. Cyanosis and dyspnea
• B. Productive cough and high fever
• C. Barking cough and inspiratory stridor
• D. Pale laryngeal and dyspnea

Correct answer: C

Rationale: The correct answer is C: 'Barking cough and inspiratory stridor.' Classic signs of laryngotracheobronchitis (LTB) include a barking cough, often described as a seal-like cough, and inspiratory stridor, which is a high-pitched sound heard during inspiration. These symptoms occur due to inflammation and narrowing of the upper airway. Choices A, B, and D are incorrect as they do not align with the typical assessment findings of LTB. Cyanosis and dyspnea (Choice A) may occur in severe cases but are not specific to LTB. Productive cough and high fever (Choice B) are more indicative of lower respiratory tract infections. Pale laryngeal and dyspnea (Choice D) are not characteristic findings of LTB.

4. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?

• A. Give only an opioid analgesic at this time.
• B. Increase the dosage of analgesic until the child is adequately sedated.
• C. Plan a preventive schedule of pain medication around the clock.
• D. Give the child a clock and explain when they can have pain medications.

Correct answer: C

Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.

5. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. What is the best explanation for this considering cultural differences?

• A. The parent feels inferior to the nurse
• B. The parent is showing respect for the nurse
• C. The parent is embarrassed to seek health care
• D. The parent feels responsible for her child's illness

Correct answer: B

Rationale: In many Asian cultures, avoiding eye contact is a sign of respect, especially towards authority figures such as healthcare providers.

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