Nursing Elites

1. When preparing to insert an intravenous catheter for a 7-year-old child, which of the following actions should a healthcare professional take?

• A. Apply an anesthetic cream to the insertion site 1 hr before the procedure.
• B. Use a 16-gauge needle for the insertion.
• C. Insert the catheter into a vein of the child's dominant hand.
• D. Choose a site over the child's metacarpal veins.

Correct answer: A

Rationale: Applying an anesthetic cream to the insertion site 1 hr before the procedure is crucial when inserting an intravenous catheter in a child to minimize pain and discomfort during the procedure. This practice is especially important in pediatric patients to ensure a more comfortable experience and improve cooperation during the insertion process. Choice B is incorrect as a 16-gauge needle is too large for a child, and a smaller gauge needle is typically used. Choice C is incorrect as the catheter should be inserted into a suitable vein, not specifically the dominant hand vein. Choice D is incorrect as metacarpal veins are usually avoided due to their small size and the potential for complications.

2. The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, what should the nurse include in the plan of care to address pain?

• A. Applying a warm, moist pack every 4 hours
• B. Applying EMLA cream to the incision site prior to ambulation
• C. Applying a cold, moist pack every 2 hours
• D. Applying a pillow against the abdomen to splint the incision site when coughing

Correct answer: D

Rationale: After an appendectomy, applying a pillow against the abdomen to splint the incision site when coughing helps reduce pain by providing support and minimizing movement that could cause discomfort.

3. A parent of a child with attention deficit hyperactivity disorder (ADHD) is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Administer methylphenidate at bedtime.
• B. Increase stimuli in the child's environment.
• C. Administer an extra dose of medication if the child is overactive.
• D. Maintain a consistent bedtime routine.

Correct answer: D

Rationale: Maintaining a consistent bedtime routine is essential for children with ADHD as it helps in managing their symptoms effectively. Consistency in bedtime routines aids in regulating the child's sleep patterns, promoting better rest, and ultimately improving their behavior and focus during the day.

4. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?

• A. Compensating
• B. Adapting
• C. Grading
• D. Modifying

Correct answer: C

Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.

5. During a well-child visit, a nurse is assessing a three-year-old toddler. Which of the following manifestations should the nurse report to the provider?

• A. Blood pressure 90/50
• B. Respiratory rate 45/min
• C. Weight 14.5 kg or 32 lb
• D. Heart rate 110/min

Correct answer: B

Rationale: A respiratory rate of 45/min is above the expected reference range for a 3-year-old toddler and may indicate respiratory dysfunction or acute respiratory distress. It is essential for the nurse to report this finding promptly to the healthcare provider for further evaluation and intervention.

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