Nursing Elites

1. The mother of a one-month-old calls the clinic to report that the back of her infant's head is flat. How should the nurse respond?

• A. Turn the infant on the left side braced against the crib when sleeping.
• B. Prop the infant in a sitting position with a cushion when not sleeping.
• C. Place a small pillow under the infant's head while lying on the back.
• D. Position the infant on the stomach occasionally when awake and active.

Correct answer: D

Rationale: Positioning the infant on the stomach occasionally when awake and active can help prevent flat spots on the head. This position allows for more natural movement and prevents prolonged pressure on one area of the head, reducing the risk of developing a flat spot. Turning the infant on the left side braced against the crib when sleeping (choice A) is not recommended as it does not address the issue of flat spots. Propping the infant in a sitting position with a cushion when not sleeping (choice B) may increase the risk of falls and is not suitable for a one-month-old. Placing a small pillow under the infant's head while lying on the back (choice C) should be avoided due to the risk of suffocation and sudden infant death syndrome (SIDS).

2. Which assessment finding should the healthcare provider identify as most concerning in a child with acute glomerulonephritis?

• A. Hypertension.
• B. Gross hematuria.
• C. Proteinuria.
• D. Periorbital edema.

Correct answer: A

Rationale: In a child with acute glomerulonephritis, hypertension is the most concerning assessment finding as it can indicate worsening renal function. Hypertension is a common complication of glomerulonephritis and can lead to further kidney damage if not managed promptly. Monitoring and controlling blood pressure is crucial in these cases to prevent complications and preserve renal function. Gross hematuria, proteinuria, and periorbital edema are also common findings in acute glomerulonephritis but hypertension poses a higher risk for renal damage if left uncontrolled.

3. A 16-year-old adolescent is admitted to the hospital with a diagnosis of meningitis. The nurse notes that the client has a severe headache and photophobia. What is the nurse’s priority action?

• A. Administer prescribed pain medication
• B. Place the client in a dark, quiet room
• C. Notify the healthcare provider
• D. Encourage the client to rest

Correct answer: B

Rationale: The priority action for the nurse when a client with meningitis presents with a severe headache and photophobia is to place the client in a dark, quiet room. This intervention helps reduce stimuli that can exacerbate symptoms such as headache and photophobia. Creating a calm environment can provide relief and promote comfort for the client while also supporting their recovery. Administering pain medication may be necessary but ensuring a suitable environment takes precedence. Notifying the healthcare provider is important but is not the immediate priority. Encouraging rest is beneficial, but creating an appropriate environment to alleviate symptoms is the initial essential step.

4. A 4-year-old child is brought to the clinic with complaints of ear pain and fever. The practical nurse suspects otitis media. Which symptom supports this suspicion?

• A. Clear nasal discharge.
• B. Dry, hacking cough.
• C. Tugging at the ear.
• D. Sore throat.

Correct answer: C

Rationale: Tugging at the ear is a common symptom in children with otitis media. It often indicates discomfort or pain in the ear, suggesting inflammation or infection in the middle ear. This behavior is frequently observed in young children who are unable to express their discomfort verbally, making it a significant clinical indicator for otitis media in this age group. Clear nasal discharge (Choice A) is more indicative of a cold or allergies, while a dry, hacking cough (Choice B) is not typically associated with otitis media. Although a sore throat (Choice D) can sometimes accompany ear infections, tugging at the ear is a more specific and reliable symptom in this case.

5. A 2-year-old child with respiratory syncytial virus (RSV) is being treated in the hospital. What should the healthcare provider monitor for in this child?

• A. Increased urine output.
• B. Decreased respiratory rate.
• C. Labored breathing.
• D. Improved appetite.

Correct answer: C

Rationale: Labored breathing is a critical sign of worsening respiratory distress in children with RSV. It indicates that the child's condition may be deteriorating, requiring prompt intervention to ensure adequate oxygenation and prevent respiratory failure. Monitoring for labored breathing allows healthcare providers to promptly assess and manage the child's respiratory status, potentially preventing further complications associated with RSV infection.

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