Nursing Elites

1. A healthcare professional is preparing to administer a vaccine to a child who has hemophilia. Which of the following actions should the healthcare professional take?

• A. Administer the vaccine subcutaneously
• B. Administer the vaccine intramuscularly
• C. Use a 1-inch needle
• D. Apply pressure to the site for 1 to 2 minutes

Correct answer: B

Rationale: Administering the vaccine intramuscularly to a child with hemophilia is preferred to reduce the risk of bleeding. Hemophiliac individuals have a decreased ability to form blood clots, and administering vaccines intramuscularly reduces the risk of bleeding compared to subcutaneous administration. Using an appropriate needle length and applying pressure to the site post-injection are important steps, but choosing the intramuscular route is crucial in this case to minimize bleeding complications.

2. What does a Z-score of -3.00 indicate?

• A. The child's score indicates he is ahead of his peers and performing well
• B. The child's score places him within normal limits on this test item
• C. The test is inconclusive
• D. The child's score falls below the majority of his peers on this test

Correct answer: D

Rationale: A Z-score of -3.00 indicates that the child's performance is significantly below the average of their peers. It represents an extreme low score, indicating a substantial deviation from the mean performance of the group.

3. What side effect should the nurse include in the parent teaching for a child prescribed a baclofen pump for cerebral palsy?

• A. Diarrhea
• B. Hypertonia
• C. Hypotonia
• D. Restlessness

Correct answer: C

Rationale: When a child is prescribed a baclofen pump for cerebral palsy, one of the common side effects to include in parent teaching is hypotonia. Baclofen, a muscle relaxant, can lead to decreased muscle tone, resulting in hypotonia. It is important for parents to be aware of this potential side effect and know how to respond accordingly.

4. A patient is prescribed Lisinopril as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug?

• A. Weight gain of 5 pounds in 1 week
• B. Potassium level of 3.5mEq/L
• C. Crackles in the lungs are no longer heard
• D. Jugular vein distention

Correct answer: C

Rationale: The correct answer is C. Lisinopril, an ACE inhibitor, promotes venous dilation, which helps reduce pulmonary congestion and peripheral edema. The absence of previously heard crackles in the lungs indicates effectiveness in reducing pulmonary congestion. Edema and jugular vein distention are signs of heart failure and would not indicate the therapeutic effect of Lisinopril. A potassium level of 3.5mEq/L is within the normal range and not directly related to the therapeutic effect of Lisinopril.

5. Which strategy is most effective in preventing existing challenging behaviors?

• A. Ignoring the behaviors
• B. Individualized interventions
• C. Providing flexible rules
• D. Punishment

Correct answer: B

Rationale: Individualized interventions are tailored to address the specific needs and triggers of the individual's challenging behaviors. By customizing the approach to each person, it increases the likelihood of effectively preventing and managing the existing challenging behaviors.

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