Nursing Elites

1. During the nurse’s initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. What action should the nurse take?

• A. Reassess the child in 15 minutes to see if the pain rating has changed
• B. Administer the prescribed analgesic
• C. Do nothing since the child appears to be resting
• D. Ask the child’s parents if they think the child is hurting

Correct answer: B

Rationale: Pain management should be based on the child’s report of pain, regardless of their activity level. Administering the prescribed analgesic is the appropriate action. Reassessing the child in 15 minutes without providing immediate pain relief may not be in the child's best interest. Doing nothing since the child appears to be resting may lead to inadequate pain management. Asking the child’s parents if they think the child is hurting does not replace the need for direct assessment and intervention by the nurse.

2. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her child's oiled skin. The nurse should recognize this as what?

• A. Child abuse
• B. Cultural practice to rid the body of disease
• C. Cultural practice to treat enuresis or temper tantrums
• D. Child discipline measure common in the Vietnamese culture

Correct answer: B

Rationale: This practice, known as "coining," is a cultural method believed to rid the body of illness and is not indicative of child abuse.

3. What is the recommended position for a child with epiglottitis to ease breathing?

• A. Supine
• B. Prone
• C. Tripod
• D. Semi-Fowler’s

Correct answer: C

Rationale: The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler’s) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler’s position do not facilitate optimal air exchange in these cases.

4. The nurse is teaching parents about potential causes of colic in infancy. Which should the nurse include in the teaching session?

• A. Overeating
• B. All are applicable
• C. Frequent burping
• D. Parental smoking

Correct answer: B

Rationale: Overeating, swallowing excessive air (leading to frequent burping), and parental smoking are known to contribute to colic in infants. Understimulation is not typically associated with colic.

5. Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge?

• A. Chromosome analysis will be complete in 7 days.
• B. A physical examination will be able to provide a definitive answer.
• C. Additional laboratory testing is necessary to assign the correct gender.
• D. Gender assignment involves collaboration between the parents and a multidisciplinary team.

Correct answer: D

Rationale: Gender assignment in cases of ambiguous genitalia is a complex process that requires a multidisciplinary approach, including genetic, endocrinological, and psychological evaluations. The decision should be made collaboratively with the parents.

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