Nursing Elites

1. What should parents be taught when a 7-year-old child with a history of seizures is being discharged from the hospital?

• A. Administer antiepileptic medication as prescribed
• B. Ensure the child receives adequate sleep
• C. Restrict the child's activities to prevent seizures
• D. Teach seizure first aid to family members

Correct answer: D

Rationale: Teaching seizure first aid to family members is crucial in ensuring the child's safety during a seizure. This education empowers family members to respond effectively, protect the child from injury, and provide appropriate care. Option A is incorrect because antiepileptic medication should be administered as prescribed, not only when a seizure occurs. Option B, while important for overall health, is not specific to managing seizures. Option C is incorrect as there is no evidence that restricting activities prevents seizures, and it may negatively impact the child's quality of life without offering additional safety benefits.

2. A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?

• A. Avoid triggers that cause flare-ups
• B. Apply topical corticosteroids as prescribed
• C. Use a soft toothbrush for oral care
• D. Avoid contact with sick individuals

Correct answer: B

Rationale: The correct answer is to 'Apply topical corticosteroids as prescribed.' Atopic dermatitis is a condition characterized by inflammation and itchiness of the skin. Topical corticosteroids are commonly used to reduce inflammation and relieve symptoms in atopic dermatitis. Teaching the caregiver to apply the medication as prescribed by the healthcare provider is crucial for managing the child's condition effectively. Choices A, C, and D are not the priority discharge teaching for atopic dermatitis. While avoiding triggers that cause flare-ups and contact with sick individuals can be beneficial, the immediate focus should be on proper medication administration to address the underlying inflammation and symptoms of atopic dermatitis.

3. A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the nurse’s best initial action?

• A. Attempt to open the jaw.
• B. Place the child on the floor.
• C. Call out for assistance from staff.
• D. Place a pillow under the child’s head.

Correct answer: B

Rationale: The correct initial action during a tonic-clonic seizure is to place the child on the floor to prevent injury. This action helps protect the child from falling off the chair and provides a safer environment for the seizure to occur. Attempting to open the jaw can cause harm or injury. Calling out for assistance is important but should follow the immediate action of moving the child to the floor. Placing a pillow under the child’s head is not recommended as it may lead to airway obstruction or further injury during the seizure.

4. 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 respirations 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 correct answer is C. Any vital signs outside the expected range in an infant should be documented and reported, as they may indicate a developing condition that requires prompt attention. Choice A is incorrect because slow respirations in infants should not be dismissed without assessment and documentation. Choice B is incorrect because a drop in respiratory rate in this case was significant and should have been documented. Choice D is incorrect because even though infants have underdeveloped respiratory tracts, any abnormal respiratory rate should be taken seriously and documented for monitoring and intervention if necessary.

5. What should be included in the teaching plan for parents of an infant diagnosed with phenylketonuria (PKU)?

• A. Mental retardation occurs if PKU is untreated.
• B. Testing for PKU is done immediately after birth.
• C. Treatment for PKU includes lifelong dietary management.
• D. PKU is transmitted as an autosomal recessive trait.

Correct answer: A

Rationale: The correct answer is A: 'Mental retardation occurs if PKU is untreated.' Phenylketonuria (PKU) is a metabolic disorder that results in the inability to metabolize phenylalanine properly. Without proper dietary management, high levels of phenylalanine can lead to severe mental retardation and other neurological problems. Therefore, educating parents about the importance of early and consistent treatment to prevent mental retardation is crucial. Choice B is incorrect because testing for PKU is typically done shortly after birth, not immediately. Choice C is incorrect because treatment for PKU primarily involves strict dietary management to control phenylalanine intake, not lifelong medications. Choice D is incorrect because PKU is inherited in an autosomal recessive pattern, not as an autosomal dominant gene.

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