Nursing Elites

1. For a child with Kawasaki disease, which symptom is most indicative of the acute phase?

• A. Strawberry tongue
• B. Joint pain
• C. Rash
• D. Peeling skin

Correct answer: A

Rationale: The correct answer is A: Strawberry tongue. In Kawasaki disease, a 'strawberry tongue' is most indicative of the acute phase. This refers to the tongue appearing red and swollen with enlarged fungiform papillae, giving it a strawberry-like appearance. Joint pain (Choice B) is more commonly associated with other conditions like rheumatoid arthritis. Rash (Choice C) and peeling skin (Choice D) are also seen in Kawasaki disease but are not as specific to the acute phase as the presence of a strawberry tongue.

2. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?

• A. S1 and S2
• B. S3 and S4
• C. Murmur
• D. Physiologic splitting

Correct answer: C

Rationale: A murmur is produced by turbulent blood flow within the heart or major arteries, resulting in audible vibrations.

3. The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse give regarding alopecia?

• A. Hair usually regrows in two years.
• B. When hair regrows, it may have a slightly different color or texture.
• C. Expose your head to sunlight to minimize alopecia.
• D. Wearing hats and scarves are preferred to wearing a wig.

Correct answer: B

Rationale: The correct answer is B. Hair loss from chemotherapy is usually temporary, and when it regrows, it may have a different color or texture. Sun exposure should be minimized, as the scalp may be more sensitive. Wearing hats and scarves can provide comfort and protection, but there is no preference over wearing a wig. Choice A is incorrect because hair regrowth after chemotherapy varies from person to person and usually occurs sooner than two years. Choice C is incorrect as sun exposure should be minimized to protect the sensitive scalp. Choice D is incorrect as the preference between wearing hats, scarves, or a wig is subjective and depends on the individual's comfort and preferences.

4. The nurse is providing anticipatory guidance to parents of a 4-month-old infant on preventing an aspiration injury. What should the nurse include in the teaching?

• A. Keep baby powder out of reach.
• B. Inspect toys for removable parts.
• C. Allow the infant to take a bottle to bed.
• D. Teething biscuits can be used for teething discomfort.

Correct answer: A

Rationale: Baby powder can be inhaled by the infant and cause respiratory distress. Toys should be inspected to prevent choking hazards. Allowing an infant to take a bottle to bed can increase the risk of aspiration, and hard foods like teething biscuits should be given with caution.

5. Which distraction technique should be used for an adolescent child during a painful procedure?

• A. Blowing bubbles
• B. Guided imagery
• C. EMLA cream
• D. Sucrose solution

Correct answer: B

Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.

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