Nursing Elites

1. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?

• A. Deep-breathing exercises
• B. Upright positioning
• C. Coughing
• D. Chest percussion

Correct answer: B

Rationale: Upright positioning is the optimal intervention to promote maximum chest expansion in a child with Duchenne muscular dystrophy. By placing the child in an upright position, gravity can assist in expanding the chest cavity, facilitating better lung expansion and improving breathing efficiency. Deep-breathing exercises may be beneficial but are not as effective in maximizing chest expansion as upright positioning. Coughing and chest percussion focus more on airway clearance and are not directly aimed at promoting chest expansion.

2. When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'

• A. keep medications in a medicine cabinet.
• B. have secured gates at entrances to staircases.
• C. move our child to a regular bed by the age of three.
• D. buy shoes that fasten with Velcro rather than laces.

Correct answer: C

Rationale: The correct answer is C. Moving a child to a regular bed by the age of three can increase the risk of falls as young toddlers may not have the motor skills to safely navigate a larger bed. This indicates a need for more teaching on safety measures. Choices A, B, and D are all appropriate safety measures that can help prevent accidents and injuries in young children. Keeping medications in a medicine cabinet, having secured gates at entrances to staircases, and choosing shoes that fasten with Velcro instead of laces are all good practices to ensure a safe environment for toddlers.

3. A parent asks the nurse what they can do to help their child who is experiencing night terrors. What should the nurse suggest?

• A. Encourage the child to talk about the dream
• B. Establish a bedtime routine
• C. Allow the child to sleep with the parents
• D. Wake the child during the night

Correct answer: B

Rationale: Establishing a bedtime routine is the most appropriate suggestion for a child experiencing night terrors. Consistent bedtime routines help create a sense of security and predictability, reducing the likelihood of night terrors. Encouraging the child to talk about the dream (Choice A) may not be effective as night terrors occur during non-REM sleep, and the child may not remember the dreams. Allowing the child to sleep with the parents (Choice C) can reinforce dependency and may not address the underlying causes of night terrors. Waking the child during the night (Choice D) can disrupt their sleep cycle and worsen the occurrence of night terrors.

4. What should be the focus of nursing activity for the mother of an 8-year-old girl with a broken arm, who is the nurturer in the family?

• A. Teaching proper care procedures
• B. Dealing with insurance coverage
• C. Determining the success of treatment
• D. Transmitting information to family members

Correct answer: A

Rationale: The correct answer is A: Teaching proper care procedures. In this scenario, focusing on teaching the mother proper care procedures is crucial as she is the nurturer in the family and will likely be the primary caregiver for the child. This will empower her to provide appropriate care and support for her daughter during the recovery process. Choices B, C, and D are not the most appropriate activities for the mother in this situation. Dealing with insurance coverage, determining treatment success, and transmitting information to family members are important but not as directly relevant to the immediate care needs of the child's broken arm.

5. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?

• A. Encourage participation in physical activity
• B. Provide a high-calorie diet
• C. Provide a low-sodium diet
• D. Administer intravenous fluids

Correct answer: A

Rationale: Encouraging regular physical activity is essential in managing symptoms and improving joint function in juvenile idiopathic arthritis. Physical activity helps maintain joint mobility, muscle strength, and overall function. Providing a high-calorie diet may not be necessary unless there are specific concerns about the child's nutritional status. A low-sodium diet is not typically a priority in the management of JIA unless the child has comorbid conditions requiring sodium restriction. Administering intravenous fluids is not a standard discharge teaching for JIA unless there are specific medical indications necessitating it.

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