Nursing Elites

1. A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?

• A. Dry, hacking cough
• B. Inspiratory stridor
• C. Nasal congestion
• D. Severe coughing spells

Correct answer: D

Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.

2. After completing an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?

• A. Before starting school
• B. Within the next few months
• C. When the first deciduous teeth are lost
• D. At the next dental visit of a family member

Correct answer: B

Rationale: It is recommended that a child should visit the dentist within the next few months after turning two years old. This allows for early dental check-ups to monitor oral health, detect any issues early on, and establish a good oral hygiene routine. Choice A ('Before starting school') is not as specific and may delay the child's first dental visit. Choice C ('When the first deciduous teeth are lost') is too late for the first dental visit, as preventive care should start earlier. Choice D ('At the next dental visit of a family member') is not ideal as the child's dental needs should be addressed independently of family members' visits.

3. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: C

Rationale: Avoiding gluten is not typically necessary for managing gastroesophageal reflux disease (GERD) in children. The correct dietary instruction for a 2-year-old with GERD would be to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux symptoms. While spicy foods and dairy products may also trigger reflux in some individuals, the primary focus should be on avoiding high-fat foods due to their direct impact on the lower esophageal sphincter, which exacerbates GERD symptoms.

4. The nurse is assessing a 4-year-old client. Which finding suggests to the nurse this child may have a genetic disorder?

• A. The inquiry determines the child had feeding problems.
• B. The child weighs 40 lb (18.2 kg) and is 40 in (101.6 cm) in height.
• C. The child has low-set ears with lobe creases.
• D. The child can hop on one foot but cannot skip.

Correct answer: C

Rationale: Low-set ears with lobe creases are often associated with genetic disorders, such as Down syndrome, and can indicate underlying chromosomal abnormalities. This physical characteristic is a common feature seen in various genetic syndromes. The other choices, including feeding problems, weight and height measurements, and motor skills, are not typically specific indicators of genetic disorders in the absence of other associated features.

5. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

• A. Skeletal traction
• B. Physical therapy
• C. Orthotics
• D. Occupational therapy

Correct answer: A

Rationale: When caring for a child with cerebral palsy, skeletal traction is the least likely treatment intervention. Cerebral palsy primarily involves motor function impairments, and skeletal traction is not a typical intervention for this condition. Physical therapy is commonly used to improve movement and function, orthotics help with posture and mobility, and occupational therapy addresses activities of daily living. These interventions are more aligned with the needs of a child with cerebral palsy compared to skeletal traction, making it the least likely treatment option.

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