Nursing Elites

1. A 12-year-old child had an appendectomy 18 hours ago. The nurse is monitoring the child for pain control. Which of the following tools is most appropriate for assessing the child’s pain?

• A. FLACC scale
• B. Numeric scale
• C. NIPS scale
• D. FACES scale

Correct answer: B

Rationale: The Numeric scale is the most appropriate tool for assessing pain in older children, like a 12-year-old, as they can comprehend and use numbers to indicate their pain levels accurately. The FLACC scale is typically used for nonverbal or preverbal children. The NIPS scale is designed for neonates and infants. The FACES scale is more commonly used in younger children who may have difficulty expressing their pain in other ways.

2. What statement best describes Hirschsprung disease?

• A. The colon has an aganglionic segment.
• B. It results in frequent evacuation of solids, liquid, and gas.
• C. The neonate passes excessive amounts of meconium.
• D. It results in excessive peristaltic movements within the gastrointestinal tract.

Correct answer: A

Rationale: Hirschsprung disease is characterized by the absence of ganglion cells in a segment of the colon, leading to a lack of peristalsis and obstruction. The other options do not accurately describe this condition.

3. If the needs of the infant are met in a loving, consistent manner, the infant will develop a sense of:

• A. Trust
• B. Love
• C. Independence
• D. Responsibility

Correct answer: A

Rationale: The correct answer is A: Trust. According to Erikson's psychosocial development theory, when infants receive consistent and loving care, they develop trust. This trust forms the basis of the first stage of psychosocial development, known as Trust vs. Mistrust. Trust is essential for healthy social and emotional development. Choice B, Love, is incorrect as it is more of an emotion than a developmental stage. Choice C, Independence, typically occurs later in development during Erikson's Autonomy vs. Shame and Doubt stage. Choice D, Responsibility, is also not the correct answer as it relates more to later stages of development where individuals develop a sense of duty and obligation.

4. A six-year-old child is admitted to the hospital with a diagnosis of urinary tract infection. Which of these factors contribute to urinary tract infections in young children?

• A. Excessive intake of carbonated beverages.
• B. Insufficient water intake to flush the kidneys.
• C. Voiding pattern of 5-6 times a day.
• D. Infrequent voiding which results in urinary stasis.

Correct answer: D

Rationale: Infrequent voiding can lead to urinary stasis, which increases the risk of urinary tract infections by allowing bacteria to multiply in the bladder. Encouraging regular voiding and proper hydration can help prevent UTIs. Choices A, B, and C are incorrect. Excessive intake of carbonated beverages may irritate the bladder but is not a direct cause of UTIs. Insufficient water intake can concentrate urine but does not necessarily lead to infections. A voiding pattern of 5-6 times a day is within the normal range and is not associated with increased UTI risk.

5. The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate?

• A. Retake the temperature in 15 minutes after giving the Tylenol.
• B. Place a warm blanket on the child so chilling does not occur.
• C. Check to be sure the Tylenol dose does not exceed 15 mg/kg.
• D. Use cold compresses instead of Tylenol to control the fever.

Correct answer: C

Rationale: Ensuring the dose does not exceed 15 mg/kg is critical to avoid overdose and potential liver damage. Retaking the temperature immediately or using cold compresses is not necessary, and placing a warm blanket could exacerbate the fever.

Similar Questions