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 school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?

• A. Varicella (Chickenpox)
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.

3. Which of the following parameters would be LEAST reliable when assessing the perfusion status of a 2-year-old child with possible shock?

• A. distal capillary refill
• B. systolic blood pressure
• C. skin color and temperature
• D. presence of peripheral pulses

Correct answer: B

Rationale: Systolic blood pressure is the least reliable parameter when assessing the perfusion status of a 2-year-old child with possible shock. In pediatric patients, especially young children, blood pressure may not decrease until significant shock has already occurred, making it a late indicator of inadequate perfusion. Depending solely on systolic blood pressure to evaluate perfusion status in this age group can lead to a delay in appropriate interventions. Distal capillary refill time, skin color, and temperature changes, and the presence of peripheral pulses are more sensitive and early indicators of perfusion status in pediatric patients. Monitoring distal capillary refill provides information on peripheral perfusion, while changes in skin color and temperature can signal circulatory compromise. Evaluating the presence or absence of peripheral pulses offers insights into vascular perfusion. These parameters offer more reliable and prompt feedback on a child's perfusion status compared to systolic blood pressure.

4. A 10-year-old girl is living with a foster family. Which intervention is the priority for the child in this family structure?

• A. Determining if the child is being bullied at school
• B. Dealing with mixed expectations of parents
• C. Establishing who is the child's actual caretaker
• D. Performing a comprehensive health assessment

Correct answer: D

Rationale: Performing a comprehensive health assessment is crucial for a child living with a foster family as they may have moved between different homes, leading to incomplete medical records. This assessment helps identify any existing health issues, ensure appropriate care, and address any unmet health needs. While addressing issues like bullying or parental expectations is important, the immediate priority should be ensuring the child's overall health and well-being. Establishing the actual caretaker is also important but may not be as urgent as addressing potential health concerns.

5. On the third day of hospitalization, the nurse observes that a 2-year-old toddler who had been screaming and crying inconsolably begins to regress and is now lying quietly in the crib with a blanket. What stage of separation anxiety has developed?

• A. Denial
• B. Despair
• C. Mistrust
• D. Rejection

Correct answer: B

Rationale: The correct answer is B: 'Despair'. In separation anxiety, the stage of despair is characterized by regression and withdrawal after the initial protest. The toddler's shift from intense crying to lying quietly with a blanket demonstrates this withdrawal behavior. Choice A, 'Denial', is incorrect as denial involves refusing to accept the reality of separation. Choice C, 'Mistrust', is incorrect as it relates to a lack of trust rather than the stage of separation anxiety described in the scenario. Choice D, 'Rejection', is incorrect as it does not reflect the behavior of the toddler in the scenario, which is more indicative of withdrawal and regression.

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