Nursing Elites

1. How should a nurse prepare a 15-month-old child diagnosed with hydrocephalus for a computed tomography (CT) scan?

• A. Shaving the child's head
• B. Starting the prescribed IV infusion
• C. Administering the prescribed sedative
• D. Giving the child a simple explanation of the procedure

Correct answer: D

Rationale: Preparing a toddler for a CT scan involves providing a simple explanation of the procedure to help reduce anxiety and fear. Shaving the child's head is unnecessary for a CT scan and may increase distress. Starting an IV infusion or administering sedatives may not be appropriate or necessary for all pediatric patients undergoing CT scans, especially if the child can cooperate without these interventions.

2. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: The correct dietary instruction for a child with GERD is to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux. While avoiding gluten may be necessary for individuals with gluten sensitivity or celiac disease, it is not a standard recommendation for GERD. Avoiding spicy foods and dairy products may help some individuals with GERD, but the most crucial dietary advice is to avoid high-fat foods.

3. A nurse is assessing a child with suspected rheumatic fever. What clinical manifestation is the nurse likely to observe?

• A. Jaundice
• B. Peeling skin on the hands and feet
• C. High fever
• D. Severe joint pain

Correct answer: D

Rationale: The correct answer is D, severe joint pain. Rheumatic fever commonly presents with severe joint pain due to joint inflammation. Jaundice (choice A) is not typically associated with rheumatic fever. Peeling skin on the hands and feet (choice B) is more indicative of conditions like Kawasaki disease. While a high fever (choice C) can be present, it is not as specific to rheumatic fever as severe joint pain. Severe joint pain, along with other criteria like carditis, subcutaneous nodules, erythema marginatum, and Sydenham chorea, are major criteria used in the diagnosis of rheumatic fever.

4. A child with a diagnosis of leukemia is admitted to the hospital with a fever. What is the priority nursing intervention?

• A. Administering antibiotics
• B. Administering antipyretics
• C. Providing nutritional support
• D. Monitoring for signs of infection

Correct answer: D

Rationale: The correct answer is D: Monitoring for signs of infection. When a child with leukemia presents with a fever, the priority nursing intervention is to monitor for signs of infection due to the immunocompromised state of the child. Administering antibiotics (choice A) may be necessary based on the assessment of signs of infection, but monitoring comes first. Administering antipyretics (choice B) helps to reduce fever but does not address the underlying cause. Providing nutritional support (choice C) is essential but not the priority when the child is at risk of infection.

5. A nurse is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the nurse likely to observe?

• A. Projectile vomiting
• B. Diarrhea
• C. Constipation
• D. Abdominal distension

Correct answer: A

Rationale: Projectile vomiting is the hallmark clinical manifestation of pyloric stenosis in infants. In pyloric stenosis, the muscle surrounding the opening between the stomach and the small intestine thickens, leading to obstruction. This obstruction causes forceful, projectile vomiting, which is typically non-bilious (does not contain bile) and occurs after feedings. Choices B, C, and D are incorrect because diarrhea, constipation, and abdominal distension are not typical symptoms of pyloric stenosis.

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