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. A 1-week-old infant has been in the pediatric unit for 18 hours following placement of a spica cast. The nurse observes a respiratory rate of fewer than 24 breaths/min. No other changes are noted. Because the infant is apparently well, the nurse does not report or document the slow respiratory rate. Several hours later, the infant experiences severe respiratory distress, and emergency care is necessary. What should be considered if legal action is taken?

• A. Most infants have slow respirations when they are uncomfortable.
• B. The respiratory rates of young infants are irregular, so a drop in rate is unimportant.
• C. Vital signs that are outside the expected parameters are significant and should be documented.
• D. The respiratory tract of young infants is underdeveloped, and their respiratory rate is not significant.

Correct answer: C

Rationale: In this scenario, the nurse failed to report or document the slow respiratory rate of the infant, which later led to severe respiratory distress. It is crucial to understand that any vital signs outside the expected range in an infant should be documented and reported promptly. This documentation is vital for monitoring the infant's condition, identifying potential issues, and ensuring timely intervention if needed. Choices A, B, and D are incorrect because they downplay the significance of abnormal vital signs and fail to emphasize the importance of documentation and reporting in infant care.

3. The caregiver is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching?

• A. We will leave fireworks displays to the professionals.
• B. I will set our water heater at 130 degrees.
• C. All sleepwear should be flame retardant.
• D. The handles of pots on the stove should face inward.

Correct answer: B

Rationale: The correct answer is B. Setting the water heater at 130 degrees is incorrect because water heaters should be set to no higher than 120 degrees to prevent scald burns. Choice A is correct as leaving fireworks displays to professionals reduces the risk of burns. Choice C is also correct as flame-retardant sleepwear reduces the risk of burn injuries. Choice D is correct as keeping pot handles facing inward prevents accidental spills and burns.

4. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

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

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

5. What type of play do nurses expect when observing a toddler in a playroom with other children?

• A. Parallel
• B. Solitary
• C. Cooperative
• D. Competitive

Correct answer: A

Rationale: The correct answer is A: Parallel. Toddlers typically engage in parallel play, where they play alongside but not directly with other children. This type of play is common during early childhood as children are still developing social skills and may prefer to play independently while observing others. Choice B, Solitary play, refers to a child playing alone without interacting with others. Choice C, Cooperative play, involves children playing together towards a common goal or activity. Choice D, Competitive play, emphasizes winning and outperforming others, which is less common in toddlers as they are in the stage of exploring and learning through play rather than competing.

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