Nursing Elites

1. In planning care for children, the nurse considers children’s anxiety about hospitalization. Which measure should be included in the child’s plan of care to help reduce anxiety?

• A. Therapeutic play
• B. Time-out
• C. Counseling
• D. Movies

Correct answer: A

Rationale: Therapeutic play should be included in the child’s plan of care to help reduce anxiety during hospitalization. It is an effective strategy that allows children to express their feelings, understand procedures, and reduce anxiety levels. Time-out (choice B) is not suitable for addressing anxiety related to hospitalization. Counseling (choice C) may be beneficial but is not as specifically tailored to reduce anxiety in the hospital setting as therapeutic play. Movies (choice D) may provide a temporary distraction but do not actively involve the child in addressing their emotions and fears associated with hospitalization.

2. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

• A. Send the child to his or her room if the child has one.
• B. A general rule for length of time is 1 hour per year of age.
• C. Select an area that is safe and nonstimulating, such as a hallway.
• D. If the child cries, refuses, or is more disruptive, try another approach.

Correct answer: C

Rationale: Time-outs should be in a safe, nonstimulating area, with the length typically being 1 minute per year of the child's age, not 1 hour.

3. The nurse is preparing to complete documentation on a patient's chart. Which should be included in documentation of nursing care? (Select all that apply.)

• A. Reassessments
• B. Nursing care provided
• C. Initial assessments
• D. All of the above

Correct answer: D

Rationale: Proper documentation includes reassessments, initial assessments, care provided, and the patient's response, but incident reports are typically documented separately.

4. A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?

• A. Carnitine (Carnitor)
• B. Fomepizole (Antizol)
• C. Deferoxamine (Desferal)
• D. N-acetylcysteine (Mucomyst)

Correct answer: D

Rationale: N-acetylcysteine is the specific antidote for acetaminophen poisoning, working by replenishing glutathione and preventing liver damage. The other options are antidotes for different types of poisoning (e.g., Fomepizole for methanol or ethylene glycol poisoning).

5. A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?

• A. It is unnecessary because of child’s age.
• B. It is essential because it will be an adjustment.
• C. Preparation is not needed because the colostomy is temporary.
• D. Preparation is important because the child needs to deal with negative body image.

Correct answer: B

Rationale: Preparation is essential even for a young child, as they need to adjust to the temporary colostomy and understand the changes to their body, which can be confusing and distressing without proper explanation.

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