Nursing Elites

1. The nurse is planning an educational session with a group of school-age children. Which primary task from Erikson’s theory of psychosocial development should be addressed?

• A. Establishing trust in others
• B. Developing a sense of autonomy
• C. Developing a sense of industry
• D. Establishing a sense of identity

Correct answer: C

Rationale: In Erikson’s theory of psychosocial development, school-age children typically focus on developing a sense of industry. This stage, occurring during middle childhood, involves the desire to feel competent and productive in their skills and abilities. Choices A, B, and D are incorrect because establishing trust in others (A) is related to the first stage of Erikson's theory (trust vs. mistrust) which occurs in infancy, developing a sense of autonomy (B) is linked to the second stage (autonomy vs. shame and doubt) which occurs in early childhood, and establishing a sense of identity (D) is associated with the fifth stage (identity vs. role confusion) which occurs in adolescence.

2. Which parental statement indicates correct understanding regarding pancreatic enzyme administration in the treatment of cystic fibrosis?

• A. “I will administer this medication 4 times a day.”
• B. “I will administer this medication twice a day.”
• C. “I will administer this medication with meals and snacks.”
• D. “I will administer this medication every 6 hours with meals.”

Correct answer: C

Rationale: The correct answer is C: "I will administer this medication with meals and snacks." Pancreatic enzymes should be administered with meals and snacks to aid in the digestion of nutrients in children with cystic fibrosis. Choices A, B, and D are incorrect because administering the medication without meals and snacks may not provide the necessary support for digestion needed in cystic fibrosis.

3. 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.

4. The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate?

• A. Retake the temperature in 15 minutes after giving the Tylenol.
• B. Place a warm blanket on the child so chilling does not occur.
• C. Check to be sure the Tylenol dose does not exceed 15 mg/kg.
• D. Use cold compresses instead of Tylenol to control the fever.

Correct answer: C

Rationale: Ensuring the dose does not exceed 15 mg/kg is critical to avoid overdose and potential liver damage. Retaking the temperature immediately or using cold compresses is not necessary, and placing a warm blanket could exacerbate the fever.

5. An adolescent states, “I want to be a doctor or a lawyer when I grow up because I like taking care of people.” Which Eriksonian challenge is the adolescent attempting?

• A. Identity vs. role diffusion
• B. Trust vs. mistrust
• C. Industry vs. inferiority
• D. Autonomy vs. shame and doubt

Correct answer: A

Rationale: The correct answer is A: Identity vs. role diffusion. During adolescence, individuals face the challenge of forming a cohesive sense of self and identity. In this scenario, the adolescent's desire to become a doctor or lawyer reflects the exploration of potential roles and career paths, indicating an attempt to establish a clear identity. Choices B, C, and D are incorrect. Trust vs. mistrust is a challenge experienced in infancy, industry vs. inferiority is relevant to the school-age period, and autonomy vs. shame and doubt is associated with the toddler stage, not adolescence.

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