Nursing Elites

1. During the second week of hospitalization for intravenous antibiotic therapy, a 2-year-old toddler whose family is unable to visit often smiles easily, goes to all the nurses happily, and does not express interest in the parent when the parent does visit. The parent tells the nurse, 'I am pleased about the adjustment but somewhat concerned about my child’s reaction to me.' How should the nurse respond?

• A. The child is repressing feelings towards the parent.
• B. Routines have been established, and the child feels safe.
• C. The child has given up fighting and accepts the separation.
• D. Behavior has improved because the child feels better physically.

Correct answer: C

Rationale: The correct answer is C. The child's behavior of smiling easily, interacting happily with nurses, and showing disinterest in the parent when they visit indicates that the child has emotionally withdrawn and accepted the separation. This response suggests that the child may have given up fighting against the separation from the parent due to prolonged hospitalization. Choices A, B, and D are incorrect. Choice A about the child repressing feelings towards the parent is not supported by the scenario. Choice B about routines and feeling safe does not address the emotional aspect of the child's behavior. Choice D about improved behavior due to feeling better physically does not explain the emotional dynamics at play in the child's behavior.

2. What should be the priority action when caring for a child with acute laryngotracheobronchitis?

• A. Initiate measures to reduce fever.
• B. Ensure delivery of humidified oxygen.
• C. Provide support to reduce apprehension.
• D. Continually assess the respiratory status.

Correct answer: D

Rationale: The priority action when caring for a child with acute laryngotracheobronchitis is to continually assess the respiratory status (Option D). Acute laryngotracheobronchitis can potentially lead to respiratory distress, making continuous monitoring crucial to identify early signs of deterioration and intervene promptly. While options A, B, and C are also important aspects of care, they do not take precedence over respiratory assessment in this critical situation. Initiating measures to reduce fever (Option A), ensuring oxygen delivery (Option B), and providing emotional support (Option C) are all significant interventions, but without ongoing assessment of respiratory status, there is a risk of missing potential respiratory deterioration.

3. A child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger symptoms or exacerbate the condition. By evaluating the child's diet, the nurse can identify potential triggers, ensure the child receives proper nutrition, and help manage symptoms effectively. Assessing sleep patterns, academic performance, or behavior at home, while important in a holistic assessment, are not as directly related to managing asthma symptoms as dietary intake.

4. The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. This results in impaired sodium retention and potassium excretion, leading to hyperkalemia. Therefore, the correct answer is hyperkalemia (choice B). Hypernatremia (choice A) is less likely because of the loss of sodium in Addison's disease. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with Addison's disease and are less likely to be present in this condition.

5. A healthcare provider is educating a parent group about the importance of immunizations. Which disease can be prevented by the varicella vaccine?

• A. Measles
• B. Mumps
• C. Rubella
• D. Chickenpox

Correct answer: D

Rationale: The varicella vaccine is specifically designed to prevent chickenpox. Measles, mumps, and rubella are prevented by different vaccines: Measles is prevented by the measles, mumps, and rubella (MMR) vaccine; Mumps is prevented by the MMR vaccine; and Rubella is also prevented by the MMR vaccine. Therefore, the correct answer is D, Chickenpox, as it is the disease prevented by the varicella vaccine.

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