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. Which statement best reflects the role of the therapeutic relationship in fostering positive behaviors in children?

• A. It may be used as an intervention strategy to help a child with positive behaviors
• B. The relationship with parents or teachers is more important
• C. It is not essential for the child's behaviors
• D. Children will not pay attention to the therapist

Correct answer: A

Rationale: A strong therapeutic relationship can significantly influence the development of positive behaviors in children. When a child feels connected, understood, and supported by a therapist, it can lead to better outcomes in promoting positive behaviors and emotional well-being.

3. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

4. The nurse is teaching a patient with cancer about a new prescription for a fentanyl patch, 25mcg/hr. for chronic back pain. Which statement is the most appropriate to include in the teaching plan.

• A. You will need to change this patch every day, regardless of your pain level.
• B. This type of pain medication is not as likely to cause breathing problems.
• C. With the first patch, it will take about 24hrs before you feel the full effects.
• D. Use your heating pad for the back pain. It will also improve the patch�s effectiveness.

Correct answer: C

Rationale: Full analgesic effects can take up to 24 hours to develop with fentanyl patches. Most patches are changed every 72 hours. Has the same adverse effects as other opioids, including respiratory depression. Should avoid exposing the patch to external heat sources, because this may increase toxicity.

5. When teaching a parent of a child with contact dermatitis, which instruction should the nurse include?

• A. Apply a thick layer of antibiotic ointment to the affected area.
• B. Rub the skin vigorously with a towel to dry it.
• C. Keep the child's skin dry.
• D. Apply a thin layer of corticosteroid cream to the affected area.

Correct answer: D

Rationale: The correct instruction for a child with contact dermatitis is to apply a thin layer of corticosteroid cream to the affected area. Corticosteroid cream helps reduce inflammation and itching associated with contact dermatitis. It is important to avoid using antibiotic ointment or rubbing the skin vigorously, as these can worsen the condition. Keeping the child's skin dry is generally a good practice, but in the case of contact dermatitis, corticosteroid cream application is more beneficial.

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