Nursing Elites

1. What should the nurse include in the discharge teaching for a 3-year-old child diagnosed with acute otitis media?

• A. Encourage the child to drink plenty of fluids
• B. Encourage the child to eat a balanced diet
• C. Administer pain medication as needed
• D. Apply warm compresses to the affected ear

Correct answer: A

Rationale: The correct answer is to encourage the child to drink plenty of fluids. This helps to relieve symptoms and prevent dehydration in children with acute otitis media. Encouraging a balanced diet is important for overall health but may not directly impact otitis media symptoms. While administering pain medication as needed can help manage discomfort, it is not a primary discharge teaching for this condition. Applying warm compresses to the affected ear is not typically recommended in acute otitis media cases as it can potentially worsen the infection.

2. The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

• A. We should avoid aspirin and drugs like ibuprofen.
• B. He should avoid participating in football for safety.
• C. Swimming would be a great activity.
• D. Our son cannot take any antihistamines.

Correct answer: B

Rationale: The correct answer is B. Participation in contact sports like football should be avoided in children with idiopathic thrombocytopenia due to the increased risk of bleeding. Choices A, C, and D are incorrect because avoiding aspirin and drugs like ibuprofen, engaging in activities like swimming, and avoiding antihistamines are all appropriate recommendations for a child with idiopathic thrombocytopenia to prevent bleeding episodes and ensure safety.

3. A 2-year-old 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: B

Rationale: The correct dietary instruction for a 2-year-old child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye that can worsen GERD symptoms. Avoiding gluten can help reduce inflammation and discomfort in the esophagus. Choices A, C, and D are incorrect because spicy foods, high-fat foods, and dairy products can exacerbate GERD symptoms. Spicy foods can irritate the esophagus, high-fat foods delay stomach emptying leading to increased acid reflux, and dairy products can stimulate acid production, all of which can worsen GERD symptoms.

4. A parent asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent about rubeola that is different from rubella?

• A. High fever and Koplik spots
• B. Rash on the trunk with pruritus
• C. Nausea, vomiting, and abdominal cramps
• D. Characteristics of a cold, followed by a rash

Correct answer: A

Rationale: Rubeola (measles) is characterized by a high fever and the presence of Koplik spots, which are not seen in rubella (German measles). Therefore, the correct answer is A. Choice B, rash on the trunk with pruritus, is more indicative of rubella rather than rubeola. Choice C, nausea, vomiting, and abdominal cramps, are not specific differentiating symptoms between rubeola and rubella. Choice D, characteristics of a cold followed by a rash, does not specifically distinguish between rubeola and rubella.

5. A child has been diagnosed with classic hemophilia. A nurse teaches the child’s parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?

• A. Whenever a bleed is suspected
• B. In the morning on scheduled days
• C. At bedtime while the child is lying quietly in bed
• D. On a regular schedule at the parents’ convenience

Correct answer: B

Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.

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