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. The parents of a 3-month-old infant are being educated by the healthcare provider about safe sleep practices. Which statement by the parents indicates a need for further teaching?

• A. We will place our baby on their back to sleep
• B. We will use a firm mattress and avoid soft bedding
• C. We will keep our baby in our bed so we can monitor them closely
• D. We will avoid putting toys or pillows in the crib

Correct answer: C

Rationale: The correct answer is C. Co-sleeping, or keeping the baby in the parents' bed, increases the risk of sudden infant death syndrome (SIDS). It is crucial for parents to place the baby in a separate crib or bassinet to ensure a safe sleep environment and reduce the risk of SIDS. Choices A, B, and D demonstrate understanding of safe sleep practices by mentioning placing the baby on their back, using a firm mattress and avoiding soft bedding, and not putting toys or pillows in the crib, which are all measures to promote safe sleep and reduce the risk of SIDS.

3. A mother brings her 3-month-old infant to the clinic, concerned about frequent vomiting after feeding. The practical nurse (PN) suspects gastroesophageal reflux (GER). Which recommendation should the PN provide to the mother?

• A. Feed the infant in a prone position.
• B. Provide larger, less frequent feedings.
• C. Keep the infant upright for 30 minutes after feeding.
• D. Offer only formula thickened with rice cereal.

Correct answer: C

Rationale: The correct recommendation for reducing symptoms of gastroesophageal reflux (GER) in infants is to keep the infant upright for 30 minutes after feeding. This position helps prevent the backflow of stomach contents, alleviating symptoms of reflux. Placing the infant in a prone position or providing larger, less frequent feedings may worsen symptoms by increasing the likelihood of regurgitation. Offering only formula thickened with rice cereal is not the first-line intervention for GER and should not be recommended initially.

4. When obtaining the nursing history of a 7-year-old child admitted to the hospital with acute glomerulonephritis (AGN), which finding should the nurse expect to obtain?

• A. High blood cholesterol level on routine screening.
• B. Increased thirst and urination.
• C. A recent strep throat infection.
• D. A recent DPT immunization.

Correct answer: C

Rationale: When assessing a child with acute glomerulonephritis (AGN), a common trigger to expect in the nursing history is a recent strep throat infection. AGN can be triggered by a streptococcal infection, leading to the deposition of immune complexes in the glomeruli. This finding is crucial as it helps identify a potential cause for the development of AGN in the child. Choices A, B, and D are incorrect as high blood cholesterol levels, increased thirst and urination, and recent DPT immunization are not directly associated with triggering acute glomerulonephritis in children.

5. The nurse is caring for a 4-year-old child who is hospitalized with pneumonia. The child is receiving IV antibiotics and oxygen therapy. The nurse notes that the child’s respiratory rate is 40 breaths per minute, and the oxygen saturation is 92%. What is the nurse’s priority action?

• A. Increase the child’s oxygen flow rate
• B. Notify the healthcare provider
• C. Encourage the child to take deep breaths
• D. Auscultate the child’s lung sounds

Correct answer: D

Rationale: In this scenario, the child is hospitalized with pneumonia, receiving IV antibiotics and oxygen therapy. With a high respiratory rate and decreased oxygen saturation, auscultating the child’s lung sounds is the priority action. This assessment can provide crucial information about the child’s respiratory status, such as the presence of adventitious sounds or decreased air entry, which can guide further interventions and help in evaluating the effectiveness of the current treatments. Increasing the oxygen flow rate may not address the underlying issue causing the decreased oxygen saturation. Notifying the healthcare provider can be necessary but auscultating lung sounds should be done first to gather more information. Encouraging the child to take deep breaths is important for respiratory function but should not be the immediate priority in this situation.

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