Nursing Elites

1. A 7-year-old child with sickle cell anemia presents to the emergency department with severe pain in the arms and legs. What is the nurse’s priority action?

• A. Administer prescribed pain medication
• B. Apply warm compresses to the affected areas
• C. Encourage the child to drink fluids
• D. Monitor the child’s oxygen saturation

Correct answer: A

Rationale: In a sickle cell crisis, pain management is a priority due to the severe pain experienced by the child. Administering prescribed pain medication is crucial to alleviate the pain and provide comfort to the child. Once pain is controlled, other comfort measures like applying warm compresses and encouraging fluid intake can be implemented. Monitoring oxygen saturation is important but not the priority action when dealing with severe pain in a sickle cell crisis.

2. When assessing a child with suspected meningitis, which finding is a characteristic sign of meningitis?

• A. High-pitched cry
• B. Tachycardia
• C. Photophobia
• D. Hypotension

Correct answer: C

Rationale: Photophobia, which is sensitivity to light, is a characteristic sign of meningitis in children. It commonly presents along with symptoms such as headache and neck stiffness. This symptom is important to recognize early for prompt diagnosis and treatment of meningitis.

3. How should the caregiver instruct on caring for a 4-month-old with seborrheic dermatitis (cradle cap) when shampooing the child's hair?

• A. Use a soft brush and gently scrub the area.
• B. Avoid scrubbing the scalp until the scales disappear.
• C. Avoid washing the child's hair more than once a week.
• D. Use soap and water and avoid shampoos.

Correct answer: A

Rationale: When dealing with seborrheic dermatitis (cradle cap) in infants, it is essential to use a soft brush and gently scrub the affected area to help remove the scales. This process can aid in managing the condition and preventing further build-up. It is important to be gentle to avoid irritating the baby's delicate skin. Choice B is incorrect as gentle scrubbing with a soft brush can help in the removal of scales. Choice C is incorrect because regular but gentle washing is recommended to manage cradle cap. Choice D is incorrect as using specialized shampoos designed for cradle cap is usually recommended over soap and water.

4. A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents?

• A. Permanent lifestyle changes need to be made to promote safety in the home
• B. The chorea or movements are temporary and will eventually disappear
• C. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged
• D. Consistent discipline is needed to help the child control the movements

Correct answer: C

Rationale: Chorea associated with rheumatic fever is usually temporary and will subside over time.

5. In a 7-year-old child with a history of asthma experiencing an acute asthma exacerbation and displaying wheezing and the use of accessory muscles to breathe, what is the nurse’s priority intervention?

• A. Administer a nebulized bronchodilator
• B. Obtain an arterial blood gas
• C. Start the child on oxygen therapy
• D. Notify the healthcare provider

Correct answer: A

Rationale: The correct answer is to administer a nebulized bronchodilator. During an acute asthma exacerbation in a child with wheezing and increased work of breathing, the priority intervention is to provide immediate bronchodilation to dilate the airways, relieve bronchospasm, and improve breathing. This intervention aims to manage the acute asthma attack effectively and prevent further respiratory distress. Obtaining an arterial blood gas, starting oxygen therapy, or notifying the healthcare provider are important actions, but administering a bronchodilator takes precedence in addressing the acute respiratory compromise.

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