Nursing Elites

1. Which type of play would be most beneficial for preparing a preschool-age child for upcoming surgery to reduce the stress of the event?

• A. Cooperative play
• B. Associative play
• C. Dramatic play
• D. Onlooker play

Correct answer: C

Rationale: Dramatic play involves role-playing, allowing children to act out scenarios and become more comfortable with them. This type of play can help reduce anxiety about upcoming events like surgery. Cooperative play involves working together towards a common goal, associative play involves loosely interacting with others, and onlooker play involves observing others play without actively participating. These types of play are not as directly related to preparing a child for surgery and reducing stress as dramatic play.

2. The nurse is caring for an infant after a cleft lip repair. Which of these measures should be included in the plan of care?

• A. Position prone
• B. Provide fluids from a cup
• C. Position supine
• D. Avoid elbow restraints

Correct answer: C

Rationale: The correct measure that should be included in the plan of care for an infant after a cleft lip repair is to position the infant supine. Placing the infant in a supine position helps protect the surgical site from injury and promotes proper healing. Choice A, 'Position prone,' is incorrect as placing the infant prone can put pressure on the surgical site and hinder healing. Choice B, 'Provide fluids from a cup,' is not directly related to the surgical care of a cleft lip repair. Choice D, 'Avoid elbow restraints,' is not specific to the postoperative care of a cleft lip repair.

3. After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?

• A. Notify the healthcare provider.
• B. Insert a new NG tube for feedings.
• C. Replace the NG tube to maintain gastric decompression.
• D. Leave the NG tube out as it may have been in long enough.

Correct answer: A

Rationale: The most appropriate action for the nurse to take in this situation is to notify the healthcare provider immediately. This is important as the removal of the NG tube can disrupt postoperative care, especially in terms of maintaining gastric decompression. Inserting a new NG tube without practitioner direction can be unsafe and is not within the nurse's scope of practice. Similarly, replacing the NG tube or leaving it out should be decided by the healthcare provider to ensure the infant's safety and appropriate postoperative care.

4. The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?

• A. Straw
• B. Spoon
• C. Sippy cup
• D. Open cup

Correct answer: D

Rationale: An open cup is recommended for feeding after cleft palate repair to prevent injury to the surgical site and avoid creating negative pressure, which could disrupt the repair.

5. A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?

• A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
• B. Reschedule the treatment for a later time
• C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
• D. Show the respiratory therapist to the playroom

Correct answer: C

Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.

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