Nursing Elites

1. A mother reports to the nurse at the pediatric clinic that her toddler has had a fever and sore throat for the past two days. The nurse observes several swollen red spots on the child's body, some of which are fluid-filled blisters. What action should the nurse take?

• A. Obtain a fluid culture from the blisters
• B. Administer a fever-reducing medication
• C. Cover the draining vesicles with a dressing
• D. Implement transmission precautions

Correct answer: D

Rationale: The presence of swollen red spots and fluid-filled blisters may indicate a contagious condition. Implementing transmission precautions is crucial to prevent the spread of the infection to others in the clinic setting.

2. What information should the practical nurse ensure the family understands about caring for a child with a tracheostomy?

• A. Cardiopulmonary resuscitation.
• B. Hygiene practices, including showering.
• C. Proper technique for tracheostomy suctioning.
• D. Application of powder around the stoma.

Correct answer: A

Rationale: The correct answer is A: Cardiopulmonary resuscitation. It is essential for families to be educated in cardiopulmonary resuscitation (CPR) to manage emergencies involving patients with tracheostomies. Maintaining a clear airway is crucial for the child's safety and well-being. Choice B, hygiene practices, although important, is not as critical as CPR in managing a tracheostomy. Choice C, the proper technique for tracheostomy suctioning, is also crucial but does not take precedence over CPR in emergency situations. Choice D, application of powder around the stoma, is not a standard practice and may not be necessary for tracheostomy care.

3. While teaching a parenting class to new parents, the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors?

• A. Children need help in developing social skills.
• B. This age group fears loss of self-control.
• C. They provide the child with a sense of security.
• D. Children must learn to deal with authority.

Correct answer: C

Rationale: Implementing discipline and limit setting for infants and toddlers is primarily important as it provides them with a sense of security. This sense of security is crucial for their emotional and psychological development, helping them feel safe and supported as they explore the world around them. Choice A is incorrect because while developing social skills is important, the primary reason for discipline and limit setting in this context is to provide security. Choice B is incorrect as it does not address the main reason for implementing discipline and limit setting. Choice D is incorrect as the primary focus is not about dealing with authority at this early stage of development.

4. During a well-baby exam, a nurse finds that a 2-month-old's right testicle is not descended into the scrotum, but the left one is palpable. What should the nurse do?

• A. Ask if the right testis has been seen in the scrotum before
• B. Address potential concerns about future fertility
• C. Schedule an ultrasound to confirm the position of the testicle
• D. Prepare to obtain a urine specimen for culture

Correct answer: A

Rationale: The correct answer is to ask if the right testis has been seen in the scrotum before. The initial step in managing an undescended testicle is to determine if it has been previously observed in the scrotum or if this is a new finding. This information is crucial in deciding the next course of action. Choice B is incorrect because addressing future fertility concerns comes after confirming the status of the testicle. Choice C is unnecessary at this stage as the first step is to gather more history. Choice D is unrelated to the issue described and is not indicated in this scenario.

5. The healthcare provider plans to screen only the highest risk children for scoliosis. Which group of children should the healthcare provider screen first?

• A. Girls between ages 10 and 14.
• B. Boys between ages 10 and 14.
• C. Boys and girls between 12 and 14.
• D. Boys and girls between 8 and 12.

Correct answer: A

Rationale: Corrected Question: The healthcare provider plans to screen only the highest risk children for scoliosis. Which group of children should the healthcare provider screen first? Girls between ages 10 and 14 are at the highest risk for scoliosis and should be screened first as they have a higher incidence of developing scoliosis during their adolescent growth spurt. Early detection and intervention can help prevent further complications associated with scoliosis. Boys between ages 10 and 14 (choice B) are not at the highest risk compared to girls in the same age group. Boys and girls between 12 and 14 (choice C) are at a lower risk compared to girls between ages 10 and 14. Boys and girls between 8 and 12 (choice D) are at a lower risk group compared to girls between ages 10 and 14.

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