Nursing Elites

1. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is maintaining strict NPO (nothing by mouth) status. This is crucial to reduce the risk of aspiration during anesthesia induction and prevent potential complications during surgery. Administering antibiotics may be a part of the treatment plan but is not a preoperative intervention. Encouraging fluid intake is contraindicated preoperatively to avoid delays in surgery and complications related to anesthesia. Monitoring for signs of infection is important postoperatively to assess for any complications that may arise due to the surgical procedure.

2. What should be the priority action when caring for a child with acute laryngotracheobronchitis?

• A. Initiate measures to reduce fever.
• B. Ensure delivery of humidified oxygen.
• C. Provide support to reduce apprehension.
• D. Continually assess the respiratory status.

Correct answer: D

Rationale: The priority action when caring for a child with acute laryngotracheobronchitis is to continually assess the respiratory status (Option D). Acute laryngotracheobronchitis can potentially lead to respiratory distress, making continuous monitoring crucial to identify early signs of deterioration and intervene promptly. While options A, B, and C are also important aspects of care, they do not take precedence over respiratory assessment in this critical situation. Initiating measures to reduce fever (Option A), ensuring oxygen delivery (Option B), and providing emotional support (Option C) are all significant interventions, but without ongoing assessment of respiratory status, there is a risk of missing potential respiratory deterioration.

3. When developing the plan of care for a child with burns requiring fluid replacement therapy, what information would the nurse expect to include?

• A. Administration of colloid initially followed by a crystalloid
• B. Determination of fluid replacement based on the type of burn
• C. Administration of most of the volume during the first 8 hours
• D. Monitoring of hourly urine output to achieve less than 1 mL/kg/hr

Correct answer: C

Rationale: The correct answer is C. In fluid replacement therapy for burns, the majority of the volume should be administered within the first 8 hours to prevent shock and maintain perfusion. Choice A is incorrect because crystalloids are typically administered first in fluid resuscitation for burns. Choice B is incorrect as fluid replacement in burn patients is primarily determined by the extent of the burn injury rather than the type of burn. Choice D is incorrect as the goal for hourly urine output in burn patients is generally higher, aiming for 1-2 mL/kg/hr in children to ensure adequate renal perfusion and prevent dehydration.

4. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?

• A. Checking blood glucose levels before meals and at bedtime
• B. Using a lancet device to obtain blood samples
• C. Using urine test strips for monitoring
• D. Recognizing signs of hypoglycemia

Correct answer: A

Rationale: Checking blood glucose levels before meals and at bedtime is essential in managing type 1 diabetes mellitus as it helps in monitoring blood sugar levels at different times of the day and adjusting insulin doses accordingly. Option B about using a lancet device to obtain blood samples is a technique rather than an emphasis on monitoring frequency. Option C suggesting the use of urine test strips is incorrect as urine test strips are not recommended for accurate real-time monitoring of blood glucose levels in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when educating about blood glucose monitoring.

5. What behavior does a toddler subjected to prolonged hospitalization with limited parental visits typically exhibit?

• A. Cheerful interactions with staff members
• B. Indications of sadness throughout the day
• C. Excessive crying when parents are not present
• D. Limited emotional response to the environment

Correct answer: D

Rationale: Toddlers subjected to prolonged hospitalization with limited parental visits often exhibit a limited emotional response to the environment. This behavior is a common coping mechanism in young children facing such situations. While cheerful interactions with staff members (choice A) may occur occasionally, the overall response tends to be subdued. Indications of sadness throughout the day (choice B) and excessive crying when parents are not present (choice C) are less typical in this scenario, as the child may have learned to suppress emotions due to the challenging circumstances.

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