Nursing Elites

1. Following treatment for iron deficiency anemia, the physician orders lab tests. Which lab value would indicate an improvement in the child’s condition?

• A. Low hemoglobin
• B. Normal platelet count
• C. High reticulocyte count
• D. Low hematocrit

Correct answer: C

Rationale: A high reticulocyte count indicates that the bone marrow is producing more red blood cells, which is a sign of recovery from anemia as the body replenishes its iron stores and increases hemoglobin levels. Low hemoglobin (Choice A) would indicate ongoing anemia rather than improvement. A normal platelet count (Choice B) and low hematocrit (Choice D) are not specific indicators of improvement in iron deficiency anemia.

2. Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?

• A. Blended
• B. Nuclear
• C. Extended
• D. Binuclear

Correct answer: C

Rationale: An extended family includes relatives such as grandparents, aunts, uncles, and other extended family members living together, beyond just the nuclear family unit.

3. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?

• A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
• B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
• C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
• D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.

Correct answer: D

Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.

4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

• A. Focus communication on the child.
• B. Use easy analogies when possible.
• C. Explain experiences of others to the child
• D. Assure the child that communication is private

Correct answer: A

Rationale: Focusing communication directly on the child aligns with their egocentric nature and helps engage them in the conversation.

5. What is the primary symptom of congenital diaphragmatic hernia in a newborn?

• A. Cyanosis
• B. Bradycardia
• C. Absent breath sounds
• D. Tachypnea

Correct answer: C

Rationale: Absent breath sounds on the affected side are a primary symptom of congenital diaphragmatic hernia. Cyanosis, bradycardia, and tachypnea may also be present but are not the primary symptom. Cyanosis is a bluish discoloration of the skin due to poor oxygenation, bradycardia is a slower than normal heart rate, and tachypnea is rapid breathing.

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