Nursing Elites

1. A 4-year-old child is admitted with a diagnosis of bacterial pneumonia. What is the priority nursing intervention?

• A. Administering antipyretics
• B. Administering antibiotics
• C. Monitoring fluid intake
• D. Providing nutritional support

Correct answer: B

Rationale: The priority nursing intervention for a 4-year-old child admitted with bacterial pneumonia is administering antibiotics. Antibiotics are essential to treat the infection, prevent its spread, and avoid potential complications. Administering antipyretics (Choice A) may help reduce fever but does not address the underlying cause of pneumonia, which is bacterial in this case. Monitoring fluid intake (Choice C) is important to maintain hydration but does not directly treat the infection. Providing nutritional support (Choice D) is crucial for overall health, but the immediate priority is to address the bacterial infection with antibiotics to prevent further complications and promote recovery.

2. What is an important nursing consideration for a child with a diagnosis of juvenile idiopathic arthritis (JIA) being treated with methotrexate?

• A. Monitor liver function tests regularly
• B. Encourage regular exercise
• C. Provide high-calorie snacks
• D. Encourage frequent handwashing

Correct answer: A

Rationale: Monitoring liver function tests regularly is crucial when a child with JIA is on methotrexate due to the potential hepatotoxicity associated with this medication. Methotrexate can lead to liver damage, hence monitoring helps in early detection and intervention. Encouraging regular exercise (Choice B) is generally good for children with JIA to maintain joint mobility and muscle strength, but it is not directly related to methotrexate therapy. Providing high-calorie snacks (Choice C) is not a priority consideration for a child on methotrexate. Encouraging frequent handwashing (Choice D) is important for infection control, but it is not specifically associated with methotrexate therapy in a child with JIA.

3. .The parents of a 6-week-old infant who was born without an immune system ask a nurse why their baby is still so healthy. How should the nurse reply?

• A. Exposure to pathogens during this time can be limited.
• B. Some antibodies are produced by the infant’s colonic bacteria.
• C. Antibodies are passively received from the mother through the placenta and breast milk.
• D. Fewer antibodies are produced by the fetal thymus during the eighth and ninth months of gestation.

Correct answer: C

Rationale: Infants receive passive immunity through antibodies from the mother during pregnancy and breastfeeding, which protect them initially.

4. What explanation should be given to a parent about the purpose of a tetanus toxoid injection for their child?

• A. Passive immunity is conferred for life.
• B. Long-lasting active immunity is conferred.
• C. Lifelong active natural immunity is conferred.
• D. Passive natural immunity is conferred temporarily.

Correct answer: B

Rationale: The correct answer is B: 'Long-lasting active immunity is conferred.' Tetanus toxoid injection provides long-lasting active immunity by stimulating the body to produce its own antibodies. Choice A is incorrect because tetanus toxoid injection does not provide passive immunity. Choice C is incorrect because the immunity conferred by the vaccine is not natural but artificially induced. Choice D is incorrect as the immunity provided by the tetanus toxoid injection is active, not passive.

5. A parent tells a nurse at the clinic, 'Each morning I offer my 24-month-old child juice, and all I hear is ‘No.’ What should I do because I know my child needs fluid?' What strategy should the nurse suggest?

• A. Offer the child a choice of two juices.
• B. Distract the child with a favorite food.
• C. Offer the child the glass in a firm manner.
• D. Allow the child to see the parent getting angry.

Correct answer: A

Rationale: Offering a choice between two options allows the child to feel a sense of control while ensuring they get the necessary fluids. Providing a choice empowers the child and increases the likelihood of cooperation. Distracting the child with food or offering the glass in a firm manner may not address the underlying issue of refusal. Allowing the child to witness the parent's anger can create a negative environment and may not help in resolving the situation positively.

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