Nursing Elites

1. A healthcare professional is preparing to administer an oral medication to a 4-year-old child. What is the best approach to gain the child's cooperation?

• A. Explain the importance of the medication to the child
• B. Allow the child to play with a favorite toy while taking the medication
• C. Offer a reward after the medication is taken
• D. Give the medication mixed with a small amount of the child's favorite food

Correct answer: B

Rationale: Allowing the child to play with a favorite toy while taking the medication is the best approach to gain cooperation. This strategy can help distract and calm the child during the medication administration process. Choice A may not be as effective with a young child who may not fully understand the explanation. Offering a reward (choice C) may reinforce negative behavior and create a dependency on rewards for cooperation. Giving the medication with food (choice D) may not always be appropriate and may not address the cooperation aspect.

2. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?

• A. Erythematous papulovesicular rash
• B. Dry, red, scaly rash with lichenification
• C. Pustular vesicles with honey-colored exudates
• D. Hypopigmented oval scaly lesions

Correct answer: B

Rationale: In atopic dermatitis, the nurse would expect to observe a dry, red, scaly rash with lichenification. Lichenification is thickened skin due to chronic scratching. Choices A, C, and D are incorrect. Erythematous papulovesicular rash is more characteristic of contact dermatitis, pustular vesicles with honey-colored exudates are seen in impetigo, and hypopigmented oval scaly lesions are typical of pityriasis alba.

3. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

• A. metabolic alkalosis due to insufficient production of acid metabolites
• B. respiratory alkalosis due to depressed respirations and retention of carbon dioxide
• C. respiratory acidosis due to impaired respirations and increased formation of carbonic acid
• D. metabolic acidosis due to the kidneys' inability to compensate for decreased carbonic acid formation

Correct answer: C

Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis. This occurs due to impaired respirations, leading to the retention of carbon dioxide and the formation of carbonic acid. Choice A is incorrect as metabolic alkalosis is not expected in this situation. Choice B is incorrect as respiratory alkalosis does not align with the scenario of impaired respirations in severe asthma attacks. Choice D is also incorrect as it describes metabolic acidosis, which is not typically associated with severe asthma attacks.

4. When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:

• A. nondisjunction.
• B. X-linked recessive inheritance.
• C. genomic imprinting.
• D. autosomal dominant inheritance.

Correct answer: A

Rationale: Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division that leads to the presence of an extra chromosome 21. This additional chromosome alters the normal genetic makeup, resulting in the characteristics associated with Down syndrome. Therefore, the correct answer is nondisjunction (Choice A). Choices B, C, and D are incorrect because Trisomy 21 is not caused by X-linked recessive inheritance, genomic imprinting, or autosomal dominant inheritance. Understanding the specific genetic mechanism involved in Trisomy 21 is crucial for grasping the basis of this chromosomal disorder.

5. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.

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