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. When caring for a child diagnosed with cystic fibrosis, what is the priority nursing intervention?

• A. Administering pancreatic enzymes
• B. Providing respiratory therapy
• C. Encouraging physical activity
• D. Encouraging frequent handwashing

Correct answer: A

Rationale: The priority nursing intervention when caring for a child with cystic fibrosis is administering pancreatic enzymes. Cystic fibrosis is a genetic disorder that affects the digestive and respiratory systems. Administering pancreatic enzymes is crucial in aiding digestion as patients with cystic fibrosis often have pancreatic insufficiency. While providing respiratory therapy and encouraging physical activity are important aspects of care for individuals with cystic fibrosis, administering pancreatic enzymes takes precedence in addressing the malabsorption issues associated with the condition. Encouraging frequent handwashing is also essential in infection control, but it is not the priority intervention specifically related to managing cystic fibrosis.

3. A nurse is caring for an infant born with exstrophy of the bladder. What does the nurse determine is the greatest risk for this infant?

• A. Infection
• B. Dehydration
• C. Urinary retention
• D. Intestinal obstruction

Correct answer: A

Rationale: Infection is the greatest risk for an infant with exstrophy of the bladder due to the exposure of the bladder and surrounding tissues. The exposed bladder increases the risk of infection as it lacks the protective covering of the skin. Dehydration (Choice B) may occur but is not the greatest risk compared to infection. Urinary retention (Choice C) is less likely due to the nature of the condition. Intestinal obstruction (Choice D) is not directly associated with exstrophy of the bladder.

4. A nurse is caring for an infant born with exstrophy of the bladder. What does the nurse determine is the greatest risk for this infant?

• A. Infection
• B. Dehydration
• C. Urinary retention
• D. Intestinal obstruction

Correct answer: A

Rationale: Infection is the greatest risk for an infant with exstrophy of the bladder due to the exposure of the bladder and surrounding tissues. The bladder mucosa and adjacent tissues being exposed increase the susceptibility to infections. Dehydration (Choice B) is not the primary concern in this condition. Urinary retention (Choice C) is less likely as exstrophy of the bladder usually presents with constant dribbling of urine. Intestinal obstruction (Choice D) is not directly related to exstrophy of the bladder.

5. A child with a diagnosis of leukemia is receiving chemotherapy. What is the most important nursing intervention?

• A. Monitor for signs of infection
• B. Monitor for signs of bleeding
• C. Monitor for signs of dehydration
• D. Monitor for signs of pain

Correct answer: A

Rationale: The most important nursing intervention for a child with leukemia receiving chemotherapy is to monitor for signs of infection. Chemotherapy suppresses the immune system, putting the child at a higher risk of developing infections. Early detection and prompt treatment of infections are crucial to prevent complications and improve outcomes. Monitoring for signs of bleeding (choice B), dehydration (choice C), and pain (choice D) are also important aspects of care, but in this scenario, the priority is to prevent and manage infections due to the compromised immune system.

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