Nursing Elites

1. A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?

• A. Administering a bronchodilator
• B. Administering an antihistamine
• C. Administering a corticosteroid
• D. Administering oxygen

Correct answer: A

Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways, making breathing easier and relieving acute symptoms of asthma. Antihistamines are not the first-line treatment for asthma exacerbations; they are more commonly used for allergic reactions. Corticosteroids are beneficial in reducing inflammation in asthma but are usually administered after bronchodilators to provide long-term control. Oxygen therapy may be necessary in severe cases of asthma exacerbation, but bronchodilators take precedence in improving airway patency and respiratory distress.

2. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. The nurse's first action is to

• A. administer 100% oxygen to relieve hypoxia
• B. administer pain medication to relieve symptoms
• C. notify the practitioner because chest syndrome is suspected
• D. notify the practitioner because the child may be having a stroke

Correct answer: C

Rationale: In a child with sickle cell anemia experiencing severe chest pain, fever, cough, and dyspnea, the priority action is to suspect acute chest syndrome, a life-threatening complication. The nurse's first action should be to notify the practitioner for immediate evaluation and intervention. Administering 100% oxygen (Choice A) may be necessary later but is not the initial priority. Administering pain medication (Choice B) should not precede notifying the practitioner, as addressing the underlying cause is crucial. The symptoms described are more indicative of acute chest syndrome than a stroke, so notifying the practitioner for chest syndrome (Choice C) takes precedence over suspecting a stroke (Choice D).

3. A child with a diagnosis of celiac disease is admitted to the hospital. What dietary restriction should the nurse teach the parents?

• 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 B: 'Avoid gluten.' Children with celiac disease must follow a gluten-free diet to prevent symptoms and intestinal damage. Gluten is a protein found in wheat, barley, and rye, which triggers an immune response in individuals with celiac disease. Choices A, C, and D are incorrect because while some individuals with celiac disease may also have lactose intolerance or may need to manage fat or sugar intake for overall health, the primary dietary restriction for celiac disease is avoiding gluten to maintain gastrointestinal health.

4. A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse’s most appropriate response?

• A. Praise the parent for the decision and encourage the plan.
• B. Ask for more specific information related to the developmental delays.
• C. Advise the parent to have the healthcare provider help choose an appropriate program.
• D. Explain that this may be a premature action and the developmental delays could disappear.

Correct answer: B

Rationale: The most appropriate response in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the child's needs and provide tailored guidance and support to the parent. Praising the parent (Choice A) before fully grasping the situation may not be beneficial. Advising the parent to involve the healthcare provider in selecting a program (Choice C) is premature without a comprehensive understanding of the child's developmental delays. Explaining that the delays might resolve on their own (Choice D) is inappropriate as it dismisses the parent's concerns and the necessity for timely and appropriate interventions.

5. Which of the following findings would indicate altered mental status in a small child?

• A. Recognition of the parents
• B. Fright at the EMT-B's presence
• C. Lack of attention to the EMT-B's presence
• D. Consistent eye contact with the EMT-B

Correct answer: C

Rationale: In small children, altered mental status can manifest as a lack of attention to the presence of unfamiliar individuals, such as the EMT-B. This lack of engagement may indicate confusion, disorientation, or impaired cognitive function. Choices A, B, and D are incorrect as recognizing parents, exhibiting fear, or maintaining consistent eye contact do not necessarily indicate altered mental status. Recognizing parents is a normal response, fear can be a typical reaction to unfamiliar situations, and making eye contact may be a sign of curiosity or comfort rather than a reflection of mental status.

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