Nursing Elites

1. A child with acetylsalicylic acid (aspirin) poisoning is being admitted to the emergency department. What early clinical manifestation does the nurse expect to assess on this child?

• A. Hematemesis
• B. Hematochezia
• C. Hyperglycemia
• D. Hyperventilation

Correct answer: D

Rationale: Early signs of aspirin poisoning include hyperventilation due to the stimulation of the respiratory center and the resultant respiratory alkalosis. Hematemesis, hematochezia, and hyperglycemia can occur later in the poisoning process or may not be directly related to aspirin toxicity.

2. Which is the single most important factor to consider when communicating with children?

• A. Presence of the child's parent
• B. Child’s physical condition
• C. Child’s developmental level
• D. Child’s nonverbal behaviors

Correct answer: C

Rationale: The child’s developmental level is the most important factor, as it determines how information should be communicated and what the child can understand.

3. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

4. A parent brings their 4-year-old child for a check-up. Which finding would concern the nurse?

• A. Ectomorphic body type
• B. Resting pulse rate of 120
• C. Weight gain of 5 lb (2.27 kg) in the past year
• D. No increase in appetite compared with that in toddler years

Correct answer: B

Rationale: A resting pulse rate of 120 is elevated for a 4-year-old and may indicate an underlying issue that needs further investigation. An ectomorphic body type is a body shape and not typically a cause for concern. Weight gain within normal limits and no significant change in appetite are generally positive findings in a growing child.

5. What should preoperative care of a newborn with an anorectal malformation include?

• A. Frequent suctioning
• B. Gastrointestinal decompression
• C. Feedings with sterile water only
• D. Supine position with head elevated

Correct answer: C

Rationale: Preoperative care for a newborn with an anorectal malformation should include feedings with sterile water only. This approach is important to avoid complications before surgery. Gastrointestinal decompression is necessary to prevent abdominal distention and potential aspiration, making choice B incorrect. Frequent suctioning and placing the newborn in a supine position with the head elevated are not typically part of the preoperative care protocol for an anorectal malformation, thus choices A and D are incorrect.

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