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. A 6-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV). What should the nurse include in the care plan?

• A. Providing small, frequent feedings
• B. Administering antibiotics
• C. Maintaining strict isolation
• D. Elevating the head of the bed

Correct answer: D

Rationale: Elevating the head of the bed is essential in the care of an infant with RSV as it helps improve breathing by reducing congestion and promoting drainage. This position also aids in maintaining patent airways and can enhance comfort for the infant. Providing small, frequent feedings (Choice A) is generally appropriate for infants but is not a specific intervention for RSV. Administering antibiotics (Choice B) is not indicated for RSV, as it is a viral infection and antibiotics are ineffective against viruses. Maintaining strict isolation (Choice C) is important to prevent the spread of infections, but it is not a direct care intervention for managing RSV symptoms.

3. When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, what does this decision indicate?

• A. The newborn has no rights.
• B. It is the same as euthanasia.
• C. It is illegal professional practice.
• D. The newborn is being allowed to die.

Correct answer: D

Rationale: When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, it means that aggressive interventions will not be pursued, allowing the newborn to die naturally. This decision is legal and ethical, respecting the principle of non-maleficence by avoiding unnecessary suffering. Choice A is incorrect because all individuals, including newborns, have rights, but the decision to withhold extraordinary care is based on ethical considerations. Choice B is incorrect as withholding care is not the same as euthanasia, which involves actively ending life. Choice C is incorrect as long as the decision is made within legal and ethical boundaries, it is not considered illegal professional practice.

4. A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What should the nurse recommend the parent to do?

• A. Administer syrup of ipecac.
• B. Call the poison control center.
• C. Take the child to the emergency department.
• D. Give the child bread dipped in milk to absorb the poison.

Correct answer: B

Rationale: In cases of potential poisoning, immediate guidance from professionals is crucial. Administering syrup of ipecac is no longer recommended routinely due to potential risks and lack of benefit. Taking the child to the emergency department is necessary in severe cases but may not always be the immediate action needed. Giving the child bread dipped in milk is not an appropriate method to manage poisoning and could potentially worsen the situation. Therefore, the most appropriate action for the nurse to recommend is to call the poison control center for expert advice on managing the situation.

5. The parents of an infant ask the nurse why their baby is scheduled to receive the intramuscular polio vaccine rather than the oral vaccine. What is the nurse’s best response?

• A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
• B. The consensus is that either can be used, since both produce the same results and are equally safe.
• C. The oral vaccine is more expensive, so the intramuscular vaccine is preferred unless it is contraindicated.
• D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.

Correct answer: A

Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine because it has a better safety profile compared to the oral vaccine. Choice B is incorrect because the AAP specifically recommends the intramuscular vaccine over the oral vaccine. Choice C is incorrect as cost is not the primary reason for preferring the intramuscular vaccine. Choice D is incorrect as the recommendation is based on safety rather than the immunocompromised status of the infant or family members.

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