Nursing Elites

1. When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school’s Parent-Teachers Association?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.

2. A 2-year-old child with a diagnosis of autism spectrum disorder is being discharged. What should the nurse include in the discharge teaching?

• A. Maintain a structured routine
• B. Encourage social interaction
• C. Use positive reinforcement
• D. Use a communication board

Correct answer: A

Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit greatly from structured routines as they provide a sense of stability and predictability, which can help reduce anxiety and improve behavior. Encouraging social interaction (Choice B) is important but may need to be approached in a structured manner to prevent overwhelming the child. Positive reinforcement (Choice C) is also beneficial for behavior management but may not address the overall need for routine and predictability that is crucial for children with autism. Using a communication board (Choice D) may be helpful for facilitating communication, but establishing and maintaining a structured routine is fundamental for supporting the child's development and well-being in managing their autism spectrum disorder.

3. The nurse is teaching a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?

• A. Myelination continues into adolescence and beyond.
• B. The process occurs in a cephalocaudal (head-to-toe) pattern.
• C. Myelination decreases the speed of nerve impulses.
• D. Myelination decreases the specificity of nerve impulses.

Correct answer: B

Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect as myelination continues into adolescence and beyond, not just during childhood. Choice C is incorrect because myelination actually increases the speed of nerve impulses rather than decreasing it. Choice D is incorrect as myelination enhances the specificity of nerve impulses, making them more efficient and precise rather than less specific.

4. What is an early sign of congestive heart failure that the nurse should recognize?

• A. tachypnea
• B. bradycardia
• C. inability to sweat
• D. increased urinary output

Correct answer: A

Rationale: Tachypnea is an early sign of congestive heart failure that nurses should recognize. Tachypnea refers to rapid breathing, which can be an indication of the body's attempt to compensate for decreased cardiac output in congestive heart failure. Bradycardia (choice B) is a slow heart rate and is not typically associated with congestive heart failure. Inability to sweat (choice C) and increased urinary output (choice D) are not specific early signs of congestive heart failure and are not typically recognized as such.

5. An infant is diagnosed with Hirschsprung disease. What nursing intervention is essential before surgery?

• A. Administering antibiotics
• B. Ensuring bowel rest
• C. Performing regular enemas
• D. Maintaining NPO status

Correct answer: D

Rationale: The correct nursing intervention essential before surgery for an infant with Hirschsprung disease is maintaining NPO (nothing by mouth) status. This is important to prevent aspiration during and after the surgical procedure. Administering antibiotics (Choice A) may be necessary in some cases but is not the priority intervention before surgery. Ensuring bowel rest (Choice B) is not directly related to preparing for surgery and may not be the most critical intervention. Performing regular enemas (Choice C) is not recommended before surgery for Hirschsprung disease as it can aggravate the condition.

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