Nursing Elites

1. The child is admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?

• A. Place the child in the Trendelenburg position.
• B. Apply moist heat to the abdomen.
• C. Allow the child to assume a position of comfort.
• D. Administer a saline enema to cleanse the bowel.

Correct answer: C

Rationale: Allowing the child to assume a position of comfort is appropriate as it helps alleviate discomfort without the risk of complications. Placing the child in the Trendelenburg position could increase intra-abdominal pressure and worsen the condition. Applying moist heat may lead to vasodilation and potential perforation in case of appendicitis. Administering a saline enema can be harmful if the appendix is inflamed or perforated.

2. When should the dressing change for a post-op pediatric patient that is expected to be very painful and frightening be performed?

• A. In the patient’s room
• B. In the treatment room
• C. After discharge when the patient is at home
• D. In the playroom

Correct answer: B

Rationale: The correct answer is B: 'In the treatment room.' Performing painful procedures in the treatment room helps the child associate their own room with safety and comfort, not pain. Choice A is incorrect because performing the dressing change in the patient’s room may create a negative association with their safe space. Choice C is incorrect as it is important to ensure proper wound care and pain management before discharge. Choice D is incorrect as the playroom may not be equipped for a sterile dressing change.

3. The nurse is caring for a non-English-speaking child and family. Which should the nurse consider when using an interpreter?

• A. Pose several questions at a time
• B. Use medical jargon when possible
• C. Communicate directly with family members when asking questions
• D. Carry on some communication in English with the interpreter about the family's needs

Correct answer: C

Rationale: The nurse should communicate directly with the family members when asking questions, ensuring the interpreter translates accurately without adding or omitting information.

4. What component should be included in the nutritional management of a child with Crohn's disease?

• A. High fiber
• B. Increased protein
• C. Reduced calories
• D. Herbal supplements

Correct answer: B

Rationale: The correct answer is B: Increased protein. Children with Crohn's disease require a diet high in protein to support growth and tissue repair. High fiber should be avoided as it can exacerbate symptoms of Crohn's disease. Reducing calories can lead to malnutrition, which is detrimental in this condition. Herbal supplements should be used cautiously and only under medical advice as they may interact with medications or worsen symptoms.

5. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?

• A. Introduce him- or herself
• B. Make the family comfortable
• C. Give assurance of privacy
• D. Explain the purpose of the interview

Correct answer: A

Rationale: Introducing oneself is the first step in establishing a rapport and setting a professional tone for the interaction.

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