Nursing Elites

1. When should the dressing change for a post-op pediatric patient that is expected to be very painful and frightening be performed?

• A. In the patient’s room
• B. In the treatment room
• C. After discharge when the patient is at home
• D. In the playroom

Correct answer: B

Rationale: The correct answer is B: 'In the treatment room.' Performing painful procedures in the treatment room helps the child associate their own room with safety and comfort, not pain. Choice A is incorrect because performing the dressing change in the patient’s room may create a negative association with their safe space. Choice C is incorrect as it is important to ensure proper wound care and pain management before discharge. Choice D is incorrect as the playroom may not be equipped for a sterile dressing change.

2. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, "Do it later, okay?" What action should the nurse take?

• A. Postpone starting the IV until the next shift.
• B. Start the IV line and then allow for expression of feelings.
• C. Change the route of the antibiotics to PO.
• D. Postpone starting the IV line until the child is ready.

Correct answer: B

Rationale: Starting the IV as planned while allowing the child to express feelings afterward helps build trust and ensures the timely administration of necessary antibiotics. Delaying the procedure or changing the route could compromise the child's treatment.

3. What is the first step in treating a child with suspected anaphylaxis?

• A. Administer oxygen
• B. Start an IV line
• C. Give epinephrine
• D. Monitor vital signs

Correct answer: C

Rationale: The correct answer is C: Give epinephrine. Administering epinephrine is the first and most critical step in treating anaphylaxis. Epinephrine rapidly reverses the symptoms of anaphylaxis, including airway swelling, hypotension, and shock. Delaying administration can lead to severe complications or death, making it essential in emergency treatment. Choice A, administering oxygen, might be necessary but should not delay the administration of epinephrine. Starting an IV line (Choice B) is important for further treatment but not the initial step. Monitoring vital signs (Choice D) is essential but comes after administering epinephrine to stabilize the child.

4. Which inpatient pediatric patient would not be able to go to the playroom due to their physical condition?

• A. A 4-year-old with chickenpox
• B. A 12-year-old with a fractured femur
• C. A 7-year-old with new-onset diabetes mellitus
• D. A 10-year-old postoperative appendectomy

Correct answer: A

Rationale: The correct answer is A. A child with chickenpox should not go to the playroom due to being contagious, as the virus can easily spread to other children. Children with fractures (choice B), new-onset diabetes mellitus (choice C), or postoperative appendectomy (choice D) do not pose a risk of spreading an infectious disease, so they can safely go to the playroom.

5. Which condition is often associated with a "ground-glass" appearance on a chest x-ray in neonates?

• A. Pneumonia
• B. Respiratory distress syndrome
• C. Bronchopulmonary dysplasia
• D. Congenital diaphragmatic hernia

Correct answer: B

Rationale: The correct answer is B, Respiratory distress syndrome. Respiratory distress syndrome often presents with a "ground-glass" appearance on a chest x-ray in neonates due to surfactant deficiency. Choice A, Pneumonia, typically appears as patchy infiltrates on chest x-ray. Choice C, Bronchopulmonary dysplasia, is characterized by hyperinflation and fibrosis, not a ground-glass appearance. Choice D, Congenital diaphragmatic hernia, usually shows mediastinal shift and bowel loops in the chest cavity on x-ray, not a ground-glass appearance.

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