Nursing Elites

1. A nurse is teaching the parents of a toddler about the signs and symptoms of lead poisoning. Which symptom should the nurse emphasize?

• A. Abdominal pain
• B. Constipation
• C. Irritability
• D. Frequent urination

Correct answer: C

Rationale: Irritability is a significant symptom of lead poisoning in toddlers and should be emphasized to parents. Lead poisoning can manifest with various symptoms, but irritability is particularly common in children exposed to lead. Abdominal pain (Choice A) is not a typical symptom of lead poisoning in toddlers. While constipation (Choice B) can occur, it is less specific and less common than irritability. Frequent urination (Choice D) is not a typical symptom associated with lead poisoning in toddlers and is less relevant for parents to recognize in this context.

2. The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which assessment findings?

• A. Arrested height and increased weight
• B. Thin, fragile skin and multiple bruises
• C. Hyperpigmentation and hypotension
• D. Blurred vision and enuresis

Correct answer: C

Rationale: The correct answer is C: Hyperpigmentation and hypotension. These findings are classic signs of Addison disease, caused by adrenal insufficiency. Hyperpigmentation results from increased ACTH stimulating melanin production, and hypotension occurs due to mineralocorticoid deficiency. Choices A, B, and D are incorrect. Arrested height and increased weight are not typical of Addison disease. Thin, fragile skin and multiple bruises are seen in conditions like Cushing's syndrome, not Addison disease. Blurred vision and enuresis are not characteristic symptoms of Addison disease.

3. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: D

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is to monitor for signs of infection. This is crucial to ensure that any potential infections are promptly identified and managed before surgery. Administering antibiotics, maintaining strict NPO status, and encouraging fluid intake are important interventions in various clinical situations but are not the priority in this scenario. Administering antibiotics may be part of the treatment plan but is typically prescribed by a physician. Maintaining NPO status is important to prevent complications related to anesthesia but may not directly address the specific needs of a child with appendicitis. Encouraging fluid intake is generally beneficial for hydration but may not be the primary concern before surgery for appendicitis.

4. During a clinical conference with a group of nursing students, the instructor is describing burn classifications. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?

• A. Skin that is reddened, dry, and slightly swollen
• B. Skin appearing wet with significant pain
• C. Skin with blistering and swelling
• D. Skin that is leathery and dry with some numbness

Correct answer: D

Rationale: Full-thickness burns, also known as third-degree burns, are characterized by a leathery, dry appearance with numbness due to nerve damage. This type of burn extends through all layers of the skin, affecting nerve endings. Choice A describes characteristics of superficial partial-thickness burns, which involve the epidermis and part of the dermis. Choice B describes characteristics of superficial burns, or first-degree burns, which only affect the epidermis. Choice C describes characteristics of superficial to mid-dermal burns, also known as second-degree burns, which involve the epidermis and part of the dermis but do not extend through all skin layers. Therefore, the correct answer is D.

5. During a nap, a 3-year-old hospitalized child wets the bed. How should the nurse respond?

• A. Ask the child to help with remaking the bed.
• B. Put clean sheets on the bed over a rubber sheet.
• C. Change the child’s clothes without discussing the incident.
• D. Explain that children should call the nurse when they need to go to the bathroom.

Correct answer: C

Rationale: When a 3-year-old hospitalized child wets the bed during a nap, the nurse should respond by changing the child's clothes without discussing the incident. This approach helps to maintain the child's dignity, avoid embarrassment, and reduce anxiety about bedwetting. Asking the child to help remake the bed (Choice A) may not be developmentally appropriate for a 3-year-old and could potentially lead to further distress. Putting clean sheets on the bed over a rubber sheet (Choice B) addresses the aftermath but does not directly address the child's needs and feelings. Explaining that children should call the nurse when they need to go to the bathroom (Choice D) may not be effective in this situation as the child may not have control over bedwetting during sleep.

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