Nursing Elites

1. When preparing a 2-year-old child for surgery, what preoperative teaching should be provided to help them understand the procedure?

• A. Explaining the procedure in simple terms
• B. Using a doll to demonstrate the procedure
• C. Showing pictures of the hospital environment
• D. Allowing the child to play with medical equipment

Correct answer: B

Rationale: The correct preoperative teaching for a 2-year-old child undergoing surgery involves using a doll to demonstrate the procedure. This method helps the child understand what to expect in a non-threatening and visual way, making the experience less intimidating. Explaining the procedure in simple terms (Choice A) may not effectively convey the details to a young child. Showing pictures of the hospital environment (Choice C) may not directly address the surgical procedure itself. Allowing the child to play with medical equipment (Choice D) can be unsafe and may not effectively prepare the child for the surgery.

2. A child with a diagnosis of bronchiolitis is admitted to the hospital. What is the most important nursing intervention?

• A. Administering bronchodilators
• B. Providing respiratory therapy
• C. Monitoring oxygen saturation
• D. Encouraging fluid intake

Correct answer: B

Rationale: The most important nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention helps to maintain airway patency and improve breathing, which are crucial in managing bronchiolitis. Administering bronchodilators (Choice A) may be a part of the treatment plan but is not the most important intervention. Monitoring oxygen saturation (Choice C) is important but falls secondary to providing direct respiratory support. Encouraging fluid intake (Choice D) is also essential but does not address the immediate respiratory needs of the child with bronchiolitis.

3. A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?

• A. Tetanus
• B. Influenza
• C. Scarlet fever
• D. Rheumatic fever

Correct answer: D

Rationale: The correct answer is D, Rheumatic fever. Rheumatic fever can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. It is characterized by inflamed joints and can lead to serious complications such as heart infections. Tetanus (choice A) is caused by a bacterial toxin affecting the nervous system, Influenza (choice B) is a viral respiratory illness, and Scarlet fever (choice C) is also caused by streptococcus but is characterized by a sandpaper-like rash and strawberry tongue. However, in the scenario described, the nurse is most concerned about the child developing rheumatic fever due to the potential serious consequences associated with it.

4. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?

• A. “Attempt to distract the child by offering a toy.”
• B. “Say nothing and allow the tantrum to continue until it ends.”
• C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
• D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”

Correct answer: B

Rationale: The best approach in dealing with a child's tantrum is to not give in to their demands. By allowing the tantrum to continue until it ends, the child learns that this behavior is not effective in getting what they want. Offering a distraction (Choice A) might temporarily calm the child but does not address the underlying issue of the tantrum. Leaving the child with a babysitter (Choice C) does not teach the child how to handle such situations. Giving in to the child's demands (Choice D) reinforces the tantrum behavior.

5. An additional defect is associated with exstrophy of the bladder. For what anomaly should the nurse assess the infant?

• A. Imperforate anus
• B. Absence of one kidney
• C. Congenital heart disease
• D. Pubic bone malformation

Correct answer: D

Rationale: The correct answer is D, pubic bone malformation. Exstrophy of the bladder is commonly associated with pubic bone malformation because the condition involves a defect in the pelvic region. Choices A, B, and C are incorrect. Imperforate anus, absence of one kidney, and congenital heart disease are not typically associated with exstrophy of the bladder.

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