Nursing Elites

1. A healthcare professional is performing hearing screenings for children at a community health fair. Which of the following children should the professional refer to a provider for a more extensive hearing evaluation?

• A. A toddler who is 18 months old and has unintelligible speech
• B. An infant who is 3 months old and has an exaggerated startle response
• C. A preschooler who is 4 years old and prefers playing with others rather than alone
• D. An infant who is 8 months old and is not yet making babbling sounds

Correct answer: D

Rationale: The healthcare professional should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a more extensive evaluation of hearing. Babbling sounds are a developmental milestone that typically occurs by 7 months of age. Delayed or absent babbling can indicate potential hearing issues that warrant further assessment.

2. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

3. A healthcare professional is assessing a child who has nephrotic syndrome. Which of the following findings should the healthcare professional expect?

• A. Hypotension
• B. Hyperglycemia
• C. Facial edema
• D. Weight gain

Correct answer: D

Rationale: In nephrotic syndrome, there is increased permeability of the glomerular filtration barrier, leading to protein loss in the urine. This results in hypoalbuminemia, causing fluid retention and edema. Therefore, weight gain due to fluid retention is a common finding in children with nephrotic syndrome.

4. When educating a parent of a child with HIV, which statement indicates an understanding of the teaching?

• A. I will notify my child's school about their condition.
• B. I will give my child the prescribed antiretroviral medication at regular intervals.
• C. I will expect my child to receive yearly immunizations.
• D. I will bring my child in for yearly skin testing.

Correct answer: B

Rationale: The correct answer is B because ensuring the child receives the prescribed antiretroviral medication at regular intervals is crucial in maintaining therapeutic levels and preventing drug resistance in a child with HIV. Choices A, C, and D are incorrect because notifying the school about the condition, expecting yearly immunizations, and bringing the child in for yearly skin testing do not directly address the essential aspect of medication adherence, which is fundamental in managing HIV in children.

5. A post-op patient has an epidural infusion of morphine sulfate. The patient�s respiratory rate declines to 8 breaths/minute. Which medication would the nurse anticipate administering?

• A. Naloxone (Narcan)
• B. Acetylcysteine (Mucomyst)
• C. Methyprednisolone (Solu-Medrol)
• D. Protamine Sulfate

Correct answer: A

Rationale: Naloxone is a narcotic antagonist that can reverse the effects, both adverse and therapeutic, of opioid narcotic analgesics.

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