Nursing Elites

1. A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102°F, is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect the child has?

• A. Measles
• B. Chickenpox
• C. Fifth disease
• D. Scarlet fever

Correct answer: A

Rationale: The nurse should suspect measles based on the symptoms described, including the presence of Koplik spots (small, red spots with blue-white centers in the mouth). Measles typically presents with fever, irritability, runny nose, and a rash that begins on the face and spreads downward. Chickenpox (choice B) presents with vesicular lesions in different stages of healing and usually starts on the trunk. Fifth disease (choice C) presents with a 'slapped cheek' rash on the face and can cause joint pain. Scarlet fever (choice D) is characterized by a sandpaper-like rash, fever, and strawberry tongue.

2. What is the most appropriate method to feed an infant born with a unilateral cleft lip and palate?

• A. Plastic spoon
• B. Cross-cut nipple
• C. Parenteral infusion
• D. Rubber-tipped syringe

Correct answer: B

Rationale: A cross-cut nipple is the most appropriate method to feed an infant born with a unilateral cleft lip and palate. Using a cross-cut nipple allows for easier feeding by modifying the flow of milk, which helps in reducing the risk of aspiration in infants with this condition. Plastic spoon, parenteral infusion, and rubber-tipped syringe are not suitable for feeding infants with cleft lip and palate. Feeding an infant with a cleft lip and palate requires special considerations to ensure safe and effective nutrition delivery.

3. When caring for an alert 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, what should be included?

• A. Back blows, abdominal thrusts, transport
• B. Oxygen, avoiding agitation, transport
• C. Assisting ventilations, back blows, transport
• D. Chest thrusts, finger sweeps, transport

Correct answer: B

Rationale: The correct approach for a child with a mild airway obstruction, respiratory distress, and normal skin color includes providing oxygen to support breathing, avoiding agitation that could worsen the situation, and arranging for transport to a healthcare facility. Option A is incorrect because abdominal thrusts are not recommended in a mild airway obstruction scenario, and back blows are typically used for choking. Option C is incorrect because assisting ventilations may not be necessary in a child with a strong cough and normal skin color. Option D is incorrect because chest thrusts are not recommended for a mild airway obstruction, and finger sweeps are used for foreign body airway obstructions.

4. A healthcare provider is assessing a child with suspected Kawasaki disease. What clinical manifestation is the healthcare provider likely to observe?

• A. Generalized rash
• B. Peeling skin on the hands and feet
• C. High fever
• D. Low-grade fever

Correct answer: B

Rationale: Peeling skin on the hands and feet is a characteristic clinical manifestation of Kawasaki disease, known as desquamation. This occurs during the convalescent phase of the illness. While Kawasaki disease is associated with a high fever, which is a common early sign, and can also present with other symptoms like conjunctivitis, mucous membrane changes, and lymphadenopathy, the peeling skin on the hands and feet is a classic feature that distinguishes Kawasaki disease from other conditions. Generalized rash is not a specific hallmark of Kawasaki disease, and low-grade fever is not typically associated with this condition. Therefore, the correct answer is B, peeling skin on the hands and feet, which is a key feature of Kawasaki disease.

5. 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: The correct answer is to test the temperature of water before bathing. This is crucial in preventing burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can be easily burned by water that is too hot. Removing small objects from the floor (Choice A) is important to prevent choking hazards but not directly related to burns. Covering electric outlets with safety plugs (Choice B) is essential to prevent electrocution but does not address the risk of burns specifically. Removing toxic substances from low areas (Choice C) is necessary to prevent poisoning but is not directly related to burns. Therefore, the priority in this scenario is to prevent burns by ensuring the water temperature is safe for the infant.

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