Nursing Elites

1. When assessing a child with a possible fracture, what would be the most reliable indicator for the nurse to identify?

• A. Lack of spontaneous movement
• B. Point tenderness
• C. Bruising
• D. Inability to bear weight

Correct answer: B

Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It refers to localized pain at a specific point, indicating a potential bone injury. Lack of spontaneous movement (Choice A) is non-specific and can be due to various reasons. Bruising (Choice C) may be present in fractures but is not as specific as point tenderness. Inability to bear weight (Choice D) can also be seen in fractures but may not always be present, making it less reliable compared to point tenderness.

2. A major developmental milestone of a toddler is the achievement of autonomy. What should the parents do to enhance their toddler’s need for autonomy?

• A. Teach the child to share with others.
• B. Help the child learn society’s roles.
• C. Teach the child to accept external limits.
• D. Help the child develop internal controls.

Correct answer: D

Rationale: Toddlers striving for autonomy need to develop internal controls to foster their independence. Teaching the child to share (Choice A) focuses more on social skills rather than autonomy. Helping the child learn society’s roles (Choice B) is important but not directly related to enhancing autonomy. Teaching the child to accept external limits (Choice C) is contrary to promoting autonomy as it emphasizes conformity to external rules rather than internal self-regulation.

3. An infant is diagnosed with Hirschsprung disease. What nursing intervention is essential before surgery?

• A. Administering antibiotics
• B. Ensuring bowel rest
• C. Performing regular enemas
• D. Maintaining NPO status

Correct answer: D

Rationale: Maintaining NPO (nothing by mouth) status is essential before surgery for a patient with Hirschsprung disease to prevent aspiration. Administering antibiotics, ensuring bowel rest, and performing regular enemas are not the priority interventions before surgery for this condition. Administering antibiotics may be necessary in the postoperative period to prevent infection, ensuring bowel rest can be beneficial but is not the priority, and performing regular enemas is not typically recommended before surgery for Hirschsprung disease.

4. A child has undergone a tonsillectomy, and a nurse is providing postoperative care. What is an important nursing intervention?

• A. Encouraging deep breathing exercises
• B. Encouraging the child to eat
• C. Administering antibiotics
• D. Applying ice to the throat

Correct answer: C

Rationale: Administering antibiotics is a crucial nursing intervention after a tonsillectomy because it helps prevent infections, which are a common postoperative complication. Encouraging deep breathing exercises (Choice A) is also important for promoting lung expansion and preventing respiratory complications. Encouraging the child to eat (Choice B) may not be appropriate immediately after a tonsillectomy due to the risk of throat irritation and discomfort. Applying ice to the throat (Choice D) is generally not recommended post-tonsillectomy as it may cause vasoconstriction and hinder the healing process.

5. A 2-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the primary goal of therapy during the acute phase?

• A. Preventing coronary artery aneurysms
• B. Reducing fever
• C. Improving cardiac function
• D. Preventing dehydration

Correct answer: A

Rationale: The primary goal of therapy during the acute phase of Kawasaki disease is to prevent coronary artery aneurysms, which are a serious complication of this condition. Coronary artery aneurysms can lead to long-term cardiovascular issues, making prevention crucial. While reducing fever and improving cardiac function are important aspects of managing Kawasaki disease, the primary focus in the acute phase is on preventing coronary artery aneurysms. Dehydration prevention is also essential but not the primary goal during the acute phase of this disease.

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