Nursing Elites

1. At a well-visit, a mother voices concern that her 30-month-old has a smaller vocabulary than other children in his daycare. The nurse should:

• A. Admit the child to the hospital
• B. Assess the child for other age-appropriate development
• C. Suggest that the child is hearing impaired
• D. Explain that the child has a significant developmental delay

Correct answer: B

Rationale: When a parent expresses concern about a child's development, it is essential to conduct a comprehensive assessment of all areas of development before jumping to conclusions. Choosing option B allows the nurse to evaluate the child for other age-appropriate developmental milestones to determine if there are any delays or concerns. Admitting the child to the hospital (option A) is not necessary at this point and may cause unnecessary stress. Suggesting hearing impairment (option C) without proper evaluation can lead to misdiagnosis. Explaining a significant developmental delay (option D) should only be done after a thorough assessment and diagnosis.

2. An eleven-year-old boy is admitted with a history of type 1 diabetes. What information about school age should the nurse use to formulate the teaching plan for daily injections?

• A. The parents do not need to learn the procedure.
• B. The child is old enough to give most of his injections.
• C. Self-injections will be possible when he is closer to adolescence.
• D. The child can learn about self-injections when he is able to reach all injection sites.

Correct answer: B

Rationale: By the age of eleven, many children are capable of administering their own insulin injections with supervision, fostering independence and better management of their diabetes. This age is appropriate for the child to take on more responsibility for their care. While parental involvement is still crucial for supervision and guidance, the child can start to learn and perform the injections themselves. Choice A is incorrect because parental involvement is important for safety and proper technique. Choice C is incorrect as waiting until closer to adolescence may delay the child's ability to manage their diabetes effectively. Choice D is incorrect as reaching injection sites is not the sole criteria; proper technique and supervision are essential.

3. As the primary caregiver for a 5-month-old baby, according to Maslow’s hierarchy of basic needs, which intervention takes the highest priority?

• A. Feeding every four hours
• B. Protection from harm
• C. Providing stimulation
• D. Providing love

Correct answer: A

Rationale: The correct answer is A: Feeding every four hours. According to Maslow’s hierarchy of needs, physiological needs, such as food, water, and warmth, take the highest priority. Ensuring that the baby is fed regularly is crucial for survival and overall health. Choice B, protection from harm, relates more to safety needs which come after physiological needs. Choice C, providing stimulation, is associated with higher-level needs like belongingness and esteem. Choice D, providing love, corresponds to esteem and self-actualization needs, which are higher in the hierarchy than physiological needs.

4. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?

• A. The parent is trying to feed the child only what the child likes most
• B. Hispanics believe the evil eye enters when a person gets cold
• C. The parent is trying to restore normal balance through appropriate hot remedies
• D. Hispanics believe an innate energy called chi is strengthened by eating soup

Correct answer: C

Rationale: In Hispanic culture, the balance between hot and cold is important, and the parent may be giving the child broth to restore this balance while avoiding "cold" foods.

5. 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.

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