Nursing Elites

1. The caregiver explains to the parent of a 2-year-old child that the toddler’s negativism is expected at this age. What need is this behavior meeting?

• A. Trust
• B. Attention
• C. Discipline
• D. Independence

Correct answer: D

Rationale: Negativism in toddlers is a common behavior at this age as they begin to assert their independence and show a desire to control their environment. Choice A, 'Trust,' does not align with the behavior of negativism, as it is more about the child's growing autonomy. Choice B, 'Attention,' while important for child development, is not the primary need being met by negativism in this context. Choice C, 'Discipline,' though important in guiding behavior, is not the underlying need being expressed through negativism. Therefore, the correct answer is D, 'Independence,' as toddlers exhibit negativism as a way to assert their independence and autonomy.

2. .A nurse is performing a physical examination on an infant with Down syndrome. For what anomaly should the nurse assess the child?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Abnormal heart sounds could indicate a congenital heart defect, which is common in infants with Down syndrome.

3. The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management?

• A. Administer a nonsteroidal anti-inflammatory drug (NSAID) as ordered.
• B. Use guided imagery and therapeutic touch.
• C. Administer meperidine as ordered.
• D. Initiate pain assessment with a standardized pain scale.

Correct answer: D

Rationale: Initiating pain assessment with a standardized pain scale is crucial in effectively managing pain during a sickle cell crisis. This initial step helps the nurse understand the severity of the pain, which guides subsequent interventions. Administering medications, such as NSAIDs or meperidine, should only be done after a thorough pain assessment to ensure appropriate and individualized treatment. Using guided imagery and therapeutic touch may be beneficial as adjunct interventions, but they should not replace the essential first step of assessing the pain level accurately.

4. A child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?

• A. Avoid spicy foods
• B. Avoid gluten
• C. Avoid high-fat foods
• D. Avoid dairy products

Correct answer: B

Rationale: The correct dietary instruction for a child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye, and it can exacerbate GERD symptoms in some individuals. Avoiding gluten can help reduce inflammation and irritation in the gastrointestinal tract, thereby alleviating symptoms of GERD. Choices A, C, and D are incorrect because while spicy foods, high-fat foods, and dairy products can trigger GERD symptoms in some individuals, avoiding gluten specifically is more relevant for managing GERD.

5. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order?

• A. Corticosteroids.
• B. Antifungals.
• C. Antibiotics.
• D. Retinoids.

Correct answer: B

Rationale: The correct answer is B: Antifungals. Candidal diaper rash is caused by a yeast infection and is best treated with antifungal agents. Corticosteroids (choice A) may worsen fungal infections by suppressing the immune response. Antibiotics (choice C) are used to treat bacterial infections, not fungal infections like candidal diaper rash. Retinoids (choice D) are not typically used to treat candidal diaper rash in infants; they are more commonly used for dermatological conditions like acne.

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