Nursing Elites

1. A middle school student was recently diagnosed with attention-deficit hyperactivity disorder (ADHD) and is having trouble with his grades. He is referred to the school nurse by the teacher because he continues to have learning problems. Which action should the school nurse take?

• A. Ask the parents to have the child seen by a clinical psychologist
• B. Ask the parents to become involved in helping the child with his homework
• C. Refer the child to the school counselor for educational testing
• D. Seek the advice of the school principal regarding the child's learning needs

Correct answer: C

Rationale: Referring the child to the school counselor for educational testing is the most appropriate action in this scenario. This step can help identify the specific learning needs of the student and determine the appropriate interventions required to support his academic success. Option A is not the immediate action needed but may be considered in the future. Option B focuses on homework assistance, which may not address the underlying learning problems. Option D involves consulting the school principal, which is not the primary role in addressing the student's learning needs.

2. An adolescent's mother calls the primary HCP's office to inquire about the results of her daughter's serum test that was drawn last week. Since it is the teenager's 18th birthday, how should the nurse respond to this mother's inquiry?

• A. Ask when the adolescent was last seen at the clinic
• B. Tell the mother to have the teenager call the clinic
• C. Provide the mother with the findings
• D. Explain that the information cannot be released without the 18-year-old's permission

Correct answer: D

Rationale: The correct response is to explain to the mother that the information cannot be released without the 18-year-old's permission. When an individual turns 18, they are legally considered an adult, and privacy laws mandate that their consent is required before sharing their medical information with others. It is crucial to respect the adolescent's autonomy and privacy rights. Choices A and C are incorrect because they involve disclosing the information without the individual's consent. Choice B is incorrect as it does not address the legal requirement for the adolescent's permission before sharing medical information.

3. The healthcare provider is preparing to administer a vaccine to a 5-year-old child. The child is visibly anxious and asks if the shot will hurt. What is the healthcare provider’s best response?

• A. It might hurt a little, but it will be over quickly
• B. It won't hurt at all, don't worry
• C. You're a big kid now, and big kids don't cry
• D. If you don't think about it, it won't hurt

Correct answer: A

Rationale: When a child expresses fear or anxiety about receiving a vaccination, it is essential for the healthcare provider to provide honest and reassuring information. Choice A acknowledges the potential for some discomfort but also reassures the child that it will be over quickly. This response validates the child's feelings while also preparing them for the procedure. Choices B, C, and D either provide false reassurance, dismiss the child's feelings, or suggest avoidance, which are not appropriate responses in this situation.

4. A 2-year-old boy begins to cry when the mother starts to leave. What is the nurse's best response in this situation?

• A. Let me read this book to you.
• B. Two years old usually stop crying the minute the parent leaves.
• C. Now be a big boy. Mommy will be back soon.
• D. Let's wave bye-bye to mommy.

Correct answer: D

Rationale: Waving bye-bye to mommy helps the child understand that the separation is temporary.

5. The nurse provides information about the human papillomavirus (HPV) vaccine to the mother of a 14-year-old adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent at this visit?

• A. Use of protective barriers during sexual activity prevents most strains of HPV infection
• B. Most adolescents are not honest about being sexually active
• C. Not all strains of HPV will be covered if given at a later date
• D. Immunity must be established to prevent future HPV infection and the risk for cervical cancer

Correct answer: D

Rationale: Administering the HPV vaccine at this visit is essential to establish immunity against HPV, thus reducing the risk of HPV infection and cervical cancer. Vaccination is a proactive measure to protect the adolescent's health in the future. Choice A is incorrect because although protective barriers can reduce the risk of HPV transmission, the vaccine provides broader protection. Choice B is incorrect as it makes a generalization about adolescent behavior that is not relevant to vaccination. Choice C is incorrect as it suggests that delaying vaccination would not impact coverage, which is inaccurate as earlier vaccination provides broader protection against HPV strains.

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