Nursing Elites

1. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?

• A. Advise bed rest until 1 week after the icteric phase.
• B. Teach infection control measures to family members.
• C. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
• D. Reassure the mother that hepatitis A cannot be transmitted to other family members.

Correct answer: B

Rationale: Teaching infection control measures is crucial as Hepatitis A is highly contagious, especially in household settings. Proper hand hygiene and avoiding sharing personal items can prevent the spread of the virus within the family. Option A is incorrect because bed rest is not typically required for hepatitis A. Option C is incorrect as the child can return to school once feeling well and no longer contagious, not necessarily after a specific duration. Option D is incorrect because hepatitis A can be transmitted through contaminated food, water, or close personal contact.

2. According to Piaget, which principle supports a nine-year-old child's understanding that an arm will look the same when the IV is removed?

• A. The principle of conservation
• B. The principle of transductive reasoning
• C. The principle of identity
• D. The principle of reflex abilities

Correct answer: A

Rationale: The correct answer is A, the principle of conservation. Piaget's principle of conservation relates to a child's ability to understand that certain properties of objects remain unchanged despite modifications in their appearance. In this case, the child's understanding that an arm will look the same after the IV is removed demonstrates conservation of appearance. Choice B, transductive reasoning, involves making faulty generalizations based on specific instances and does not apply in this context. Choice C, the principle of identity, pertains to recognizing objects as the same even if they undergo transformations, which is not directly relevant to the scenario. Choice D, reflex abilities, refers to automatic responses to stimuli and is unrelated to the child's understanding of the arm's appearance post-IV removal.

3. Which nursing action is developmentally appropriate when caring for a hospitalized school-age child?

• A. Providing brochures regarding sexuality
• B. Giving clear instructions about details of treatment
• C. Offering medical equipment to play with prior to a procedure
• D. Using toys for distraction during a painful procedure

Correct answer: C

Rationale: Offering medical equipment to play with prior to a procedure is developmentally appropriate when caring for a hospitalized school-age child. Allowing the child to familiarize themselves with the equipment helps reduce fear and anxiety about the upcoming procedure. Choices A, B, and D are not as appropriate for a school-age child. Providing brochures regarding sexuality is not developmentally appropriate for this age group. Giving clear instructions about treatment details may overwhelm a child of this age. Using toys for distraction during a painful procedure is more suitable for younger children.

4. What is the recommended position for a child after a tonsillectomy?

• A. Supine
• B. Prone
• C. Side-lying
• D. Fowler's position

Correct answer: C

Rationale: The correct answer is C: Side-lying. The side-lying position is recommended after a tonsillectomy to facilitate drainage of secretions and reduce the risk of aspiration. This position helps prevent blood from pooling in the back of the throat, decreasing the chance of bleeding postoperatively. Supine (lying face up), while commonly used in other situations, may not be ideal immediately after a tonsillectomy due to the risk of airway obstruction from blood clots. Prone (lying face down) is not recommended as it can hinder breathing and increase the risk of complications. Fowler's position (semi-sitting) is also not typically used after a tonsillectomy because it may cause discomfort and hinder proper drainage.

5. What is a common sign of moderate dehydration in children?

• A. Dry mucous membranes
• B. Normal capillary refill
• C. Hyperactive bowel sounds
• D. Edema

Correct answer: A

Rationale: Dry mucous membranes are a common sign of moderate dehydration in children, indicating a loss of bodily fluids. When a child is moderately dehydrated, the mucous membranes in the mouth and nose may appear dry. This condition can occur due to various factors such as vomiting, diarrhea, or inadequate fluid intake. Normal capillary refill (choice B) is not typically associated with dehydration; it is a measure of circulatory status. Hyperactive bowel sounds (choice C) can be present in conditions like gastroenteritis but are not specific to dehydration. Edema (choice D) is the retention of fluid in the body and is not a typical sign of dehydration.

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