Nursing Elites

1. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

• A. Limit explanation of procedures because the child is preschool-aged
• B. Ask that all family members leave the room when performing procedures
• C. Allow the child to choose the type of juice to drink with the administration of oral medications
• D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective

Correct answer: C

Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.

2. 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.

3. Urinary tract anomalies are frequently associated with what irregularities in fetal development?

• A. Myelomeningocele
• B. Cardiovascular anomalies
• C. Malformed or low-set ears
• D. Defects in lower extremities

Correct answer: C

Rationale: Malformed or low-set ears are often associated with congenital urinary tract anomalies, as both the ears and kidneys develop around the same time during fetal growth. Myelomeningocele, cardiovascular anomalies, and lower extremity defects are less commonly associated with UT anomalies.

4. The nurse is discussing sexually transmitted infections (STIs) with a 17-year-old student. Which cognitive development theory should the teaching plan be based on?

• A. Sensorimotor reactions
• B. Limited cause and effect understanding
• C. Abstract thinking
• D. Concrete thinking

Correct answer: C

Rationale: The correct answer is C: 'Abstract thinking.' According to Piaget’s theory of cognitive development, adolescents, typically around the age of 12 and older, enter the formal operational stage where they can think abstractly and reason about hypothetical situations. When discussing complex topics like STIs with a 17-year-old student, it is essential to base the teaching plan on abstract thinking. Choice A, 'Sensorimotor reactions,' is incorrect as it pertains to the earliest stage in Piaget's theory (birth to 2 years old) focusing on sensory experiences and physical interactions. Choice B, 'Limited cause and effect understanding,' does not align with the cognitive abilities of a 17-year-old who is capable of more advanced thinking. Choice D, 'Concrete thinking,' is also incorrect as it refers to the stage before formal operations, where individuals think more concretely and struggle with abstract concepts.

5. The nurse is preparing a presentation on compensated, decompensated, and irreversible shock in children. What clinical manifestations related to decompensated shock should the nurse include? (Select all that apply.)

• A. All below
• B. Oliguria
• C. Confusion
• D. Pale extremities

Correct answer: A

Rationale: Decompensated shock is characterized by signs such as oliguria, confusion, pale extremities, hypotension, and a thready pulse. These indicate that the body is no longer able to maintain adequate circulation to vital organs.

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