Nursing Elites

1. A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse?

• A. Elevate the head of the child's bed
• B. Insert a large-bore IV catheter for the child
• C. Determine the allergen that caused the child's reaction
• D. Administer IM epinephrine to the child

Correct answer: D

Rationale: In the management of anaphylaxis, the priority action for the nurse is to administer IM epinephrine to the child. Epinephrine is the first-line treatment for anaphylaxis as it helps reverse the severe manifestations of the reaction by constricting blood vessels, relaxing airway muscles, and decreasing hives and swelling. Elevating the head of the child's bed may be beneficial for respiratory distress but is not the priority over administering epinephrine. Inserting a large-bore IV catheter may be necessary for fluid resuscitation but is not the initial priority. Identifying the allergen is important for prevention and future management but is not the immediate action needed in the acute phase of an anaphylactic reaction.

2. When discussing the correction of hypospadias in a newborn, what does the nurse explain about this condition?

• A. No intervention is required as the defect will correct itself over time.
• B. Surgical repair of hypospadias is typically performed before 18 months of age.
• C. Corrective surgery is commonly postponed until preschool age.
• D. Repairing the defect does not increase the risk of testicular cancer.

Correct answer: B

Rationale: Hypospadias is a congenital condition where the opening of the urethra is on the underside of the penis. Surgical repair is the primary treatment for hypospadias and is usually recommended to be done before 18 months of age. This timing is preferred for optimal cosmetic and functional outcomes. Waiting until preschool age for corrective surgery may increase the complexity of the procedure and potential complications. Correcting hypospadias does not impact the risk of testicular cancer.

3. Which statement is not a principle of family-centered care?

• A. Respect family autonomy
• B. Provide flexible services
• C. Collaborate with family members
• D. Set strict rules for families to follow

Correct answer: D

Rationale: Family-centered care focuses on respecting family autonomy, providing flexible services, and collaborating with family members to ensure individualized care. Imposing strict rules contradicts the core principles of family-centered care, which prioritize partnership, communication, and shared decision-making between healthcare providers and families. Therefore, setting strict rules for families to follow goes against the collaborative and individualized nature of family-centered care, making it the statement that is not a principle of this approach.

4. The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child?

• A. 0.9% normal saline (NS)
• B. D5 0.2% (�) normal saline
• C. D5W
• D. Albumin

Correct answer: A

Rationale: Isotonic dehydration requires the administration of normal saline to restore fluid balance.

5. The therapist engages a teen in a game of cards to improve his hand skills for schoolwork. Which statement best reflects this session?

• A. Playfulness as an approach
• B. Play as an occupation
• C. Play as a tool
• D. Play as a reward

Correct answer: C

Rationale: The correct answer is 'Play as a tool.' In this session, the therapist is using play as a tool to integrate therapeutic goals into a playful activity, which helps engage the teen and improve specific skills, in this case, hand skills for schoolwork.

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