Nursing Elites

1. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.

2. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department, and her arm placed in a cast. At 11 p.m., her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?

• A. Notifying the doctor immediately
• B. Applying ice
• C. Elevating the arm
• D. Giving additional pain medication as ordered

Correct answer: A

Rationale: The correct action would be to notify the doctor immediately. Unrelenting pain despite medication can indicate compartment syndrome, which is a medical emergency requiring immediate attention. Applying ice or elevating the arm may not address the potential serious underlying issue of compartment syndrome. Giving additional pain medication without further assessment could delay necessary intervention and potentially worsen the condition.

3. A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?

• A. Rickets
• B. Obesity
• C. Anemia
• D. Rumination

Correct answer: B

Rationale: Childhood obesity is a prevalent issue in children with Down syndrome due to factors such as decreased physical activity, slower metabolism, and potential overeating tendencies. Addressing obesity is crucial to promoting healthy lifestyles and preventing associated health complications. Rickets, a condition caused by a deficiency of vitamin D, is not commonly associated with Down syndrome. While anemia can occur in individuals with Down syndrome, obesity is a more common concern. Rumination, the regurgitation of food without nausea, is not a typical nutritional problem in children with Down syndrome.

4. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?

• A. Acidosis
• B. Alkalosis
• C. Hyperkalemia
• D. Hypernatremia

Correct answer: B

Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.

5. A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?

• A. Administering IV immunoglobulin
• B. Monitoring for coronary artery aneurysms
• C. Encouraging fluid intake
• D. Providing nutritional support

Correct answer: B

Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to the development of coronary artery aneurysms, which are one of the most serious complications of the disease. Early detection and monitoring of coronary artery changes are essential for prompt intervention and prevention of adverse outcomes. Administering IV immunoglobulin is an important treatment for Kawasaki disease, but monitoring for coronary artery aneurysms takes precedence as it directly impacts the child's long-term prognosis. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for potential life-threatening complications.

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