Nursing Elites

1. The mother of a child with acute laryngotracheobronchitis (LTB) asks why her child must be kept NPO. Which response would be the most correct?

• A. The epinephrine given causes nausea and vomiting.
• B. The child is being hydrated with IV fluids.
• C. The child is not hungry.
• D. The child's rapid respirations pose a risk for aspiration.

Correct answer: D

Rationale: The correct answer is D because rapid respirations predispose to aspiration in a child with acute laryngotracheobronchitis. Choice A is incorrect because epinephrine does not directly relate to the need for NPO status. Choice B is incorrect as hydration with IV fluids is not the primary reason for keeping the child NPO. Choice C is incorrect as the child being hungry is not the main concern when keeping a child NPO in this situation.

2. Which other congenital defects are common in children with Down syndrome?

• A. Hypospadias
• B. Pyloric stenosis
• C. Heart defects
• D. Hip dysplasia

Correct answer: C

Rationale: The correct answer is C: Heart defects. Many children with Down syndrome are born with congenital heart defects. These heart abnormalities are more prevalent in individuals with Down syndrome than in the general population. Choices A, B, and D are incorrect because while they may be congenital defects in children, they are not commonly associated with Down syndrome. Hypospadias is a urogenital condition, pyloric stenosis affects the stomach, and hip dysplasia involves the hip joint, but these are not typically seen as frequently as heart defects in children with Down syndrome.

3. The nurse uses a diagram to show that the tetralogy of Fallot involves a combination of four congenital defects. What are the defects?

• A. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
• B. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
• C. Aortic stenosis, atrial septal defect, overriding aorta, right ventricular hypertrophy
• D. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

Correct answer: B

Rationale: The correct answer is B: Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. Tetralogy of Fallot involves these four congenital defects. Choice A is incorrect because it includes aortic stenosis instead of pulmonary stenosis, atrial septal defect instead of ventricular septal defect, and left ventricular hypertrophy instead of right ventricular hypertrophy. Choice C is incorrect as it includes aortic stenosis and atrial septal defect instead of pulmonary stenosis and ventricular septal defect. Choice D is incorrect because it includes aortic hypertrophy instead of overriding aorta.

4. A 2-year-old child with laryngotracheobronchitis (LTB) is fussy and restless in the oxygen tent. The oxygen level in the tent is 25%, and blood gases are normal. What would be the correct action by the nurse?

• A. Restrain the child in the tent and notify the health care provider.
• B. Increase the oxygen concentration in the tent.
• C. Take the child out of the tent and into the playroom.
• D. Ask the mother for help in comforting the child.

Correct answer: B

Rationale: The child with LTB should be placed in the mist tent with 30% oxygen. Restlessness is caused by poor oxygenation. The child should not be taken out of the oxygenated tent. While the mother could be asked to help comfort the child, and the health care provider may be notified, the priority is to set the oxygen at the correct level.

5. The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition?

• A. Has everyone at home already had varicella?
• B. Have the antifungal creams been effective?
• C. Do your family members share combs and brushes?
• D. Do you have any dry patches on your feet and hands?

Correct answer: A

Rationale: The correct answer is A: 'Has everyone at home already had varicella?' Herpes zoster (shingles) is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. By knowing if others at home had varicella (chickenpox), the nurse can assess the risk of transmission and provide appropriate guidance. Choice B is incorrect because antifungal creams are not effective for herpes zoster, which is a viral infection. Choice C is irrelevant to herpes zoster as it pertains to sharing personal items that may transmit head lice or certain skin infections. Choice D is also unrelated as it focuses on dry patches, not typical manifestations of herpes zoster which presents as a painful rash.

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