Nursing Elites

1. What advice should be provided by the practical nurse to the mother of a school-age child with acute diarrhea and mild dehydration who is occasionally vomiting despite being given an oral rehydration solution (ORS)?

• A. Continue to give ORS frequently in small amounts.
• B. Alternate between ORS and carbonated beverages.
• C. Take the child to the hospital for intravenous fluids.
• D. Place the child NPO for the next eight to nine hours.

Correct answer: A

Rationale: The practical nurse should advise the mother to continue providing the oral rehydration solution (ORS) frequently in small amounts. It is essential to continue ORS administration to prevent dehydration, even if the child is occasionally vomiting. Small, frequent amounts of ORS help maintain hydration levels in children with acute diarrhea and mild dehydration.

2. Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse?

• A. Plan to perform CPT when the child awakens in the morning.
• B. A cupped hand is used when percussing the lung field.
• C. A bronchodilator is administered before starting CPT.
• D. The child is placed in a supine position to begin percussion.

Correct answer: D

Rationale: The correct answer is D. Placing the child in a supine position to begin percussion is incorrect for chest physiotherapy (CPT). This position is not effective for CPT as it may lead to improper drainage of secretions. The child should be in an appropriate sitting or slightly reclined position to ensure proper lung drainage during CPT. Choices A, B, and C are all appropriate actions for chest physiotherapy. Performing CPT when the child awakens helps in clearing secretions, using a cupped hand during percussion is a proper technique to promote secretion movement, and administering a bronchodilator before CPT can help open up the airways for better clearance.

3. The nurse is caring for a 10-year-old child who is scheduled for surgery to repair a fractured femur. The child’s parent expresses concern about the child being afraid of the surgery. What is the nurse’s best response?

• A. Children at this age are usually not afraid of surgery
• B. It’s normal for your child to feel scared. Let’s talk about what to expect
• C. You should talk to the surgeon about your child’s fear
• D. Don’t worry, your child will be fine

Correct answer: B

Rationale: Acknowledging the child’s fear and providing information about what to expect can help alleviate anxiety.

4. A child receives a prescription for amantadine 42 mg PO BID. Amantadine is available as a 50 mg/5 mL syrup. Using a supplied calibrated measuring device, how many mL should be administered per dose? (Round to the nearest tenth.)

• A. 4.2 mL
• B. 5 mL
• C. 3.6 mL
• D. 4 mL

Correct answer: A

Rationale: To calculate the mL per dose, divide the prescribed dose (42 mg) by the concentration of the syrup (50 mg/5 mL) and then convert the result to mL. 42 mg / 50 mg = 0.84. To find the amount in mL, multiply 0.84 by 5 mL, which equals 4.2 mL. Therefore, 4.2 mL should be administered per dose.

5. According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence?

• A. Guilt.
• B. Shame.
• C. Alienation.
• D. Inferiority.

Correct answer: D

Rationale: Erikson's theory of psychosocial development outlines that the failure to establish a sense of competence during the industry vs. inferiority stage results in feelings of inferiority. This stage occurs during middle childhood where children strive to master skills and tasks. If they are unable to meet challenges successfully, they may start feeling inferior to their peers and may lack confidence in their abilities. Choices A, B, and C are incorrect as guilt, shame, and alienation are not the specific behavioral patterns associated with the lack of developing a sense of competence according to Erikson's theory.

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