Nursing Elites

1. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

2. What is the first-line treatment for a febrile seizure in a child?

• A. Antipyretics
• B. Anticonvulsants
• C. Cooling blankets
• D. IV fluids

Correct answer: A

Rationale: The correct answer is Antipyretics. Febrile seizures in children are usually associated with fever. The first-line treatment aims to reduce fever, which can help prevent febrile seizures. Antipyretics like acetaminophen or ibuprofen are commonly used for this purpose. Anticonvulsants, while used for treating seizures, are not typically the first-line treatment for febrile seizures as they are usually self-limited and resolve on their own. Cooling blankets can be used to lower body temperature in cases of hyperthermia but are not the primary treatment for febrile seizures. IV fluids may be administered in cases of dehydration due to fever or if the child cannot tolerate oral intake, but they are not the first-line treatment for febrile seizures.

3. When transitioning from intravenous to oral morphine, what would the nurse anticipate regarding the oral dose in comparison to the intravenous dose to achieve equianalgesia?

• A. Same as the intravenous dose
• B. Greater than the intravenous dose
• C. One half of the intravenous dose
• D. One fourth of the intravenous dose

Correct answer: B

Rationale: When switching from intravenous to oral morphine, a higher oral dose is required to achieve equianalgesia due to significant metabolism from the first-pass effect. Choosing the same oral dose as the intravenous dose would provide less pain relief. Opting for a dose greater than the intravenous dose is necessary to achieve the same analgesic effect. Therefore, options A, C, and D are incorrect.

4. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?

• A. Ethnicity
• B. Racial variation
• C. Status
• D. Geographic boundaries

Correct answer: C

Rationale: Status, or the social standing within a culture, is often culturally determined and plays a significant role in shaping behaviors and expectations.

5. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?

• A. Adapt, as necessary, ethnic practices to health needs
• B. Attempt, in a nonjudgmental way, to change ethnic beliefs
• C. Encourage continuation of ethnic practices in the hospital setting
• D. Strive to keep ethnic background from influencing health needs

Correct answer: A

Rationale: Adapting ethnic practices to health needs respects the patient's cultural background while ensuring that care is effective and culturally sensitive.

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