Nursing Elites

1. The healthcare professional is preparing to administer an immunization to a four-year-old child. Which of the following actions should the professional plan to take?

• A. Place the child in a prone position for the immunization
• B. Request that the child's caregiver stay in the room during the immunization
• C. Administer the immunization using a 24-gauge needle
• D. Inject the immunization slowly without aspirating

Correct answer: C

Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. Placing the child in a prone position for immunization is not recommended as it can be uncomfortable and may not allow for proper access to the injection site. Having the caregiver stay in the room during the immunization is beneficial for support and comfort for the child. Injecting the immunization slowly without aspirating is correct, as aspirating before administering the immunization is not required for intramuscular injections in current practice.

2. What is functional behavior analysis?

• A. Systematic observation of behavior
• B. Standardized assessment
• C. Multiple choice examination
• D. Parent-teacher questionnaire

Correct answer: A

Rationale: Functional behavior analysis involves systematically observing behavior to understand its function and context. It focuses on identifying the antecedents and consequences that maintain or influence behavior. This systematic observation helps in determining patterns, triggers, and maintaining factors of behavior. Standardized assessments (choice B) involve using specific tools or tests to measure a person's performance or behavior but do not focus on observation. Multiple choice examinations (choice C) and parent-teacher questionnaires (choice D) are not synonymous with functional behavior analysis as they do not involve direct observation of behavior for analysis.

3. Which of the following is a common issue experienced by families of children with ASD?

• A. Financial limitations
• B. Social isolation
• C. Difficulty accessing needed services
• D. Difficulty obtaining early diagnosis

Correct answer: C

Rationale: Families of children with ASD commonly experience challenges in accessing needed services. This can include difficulties in obtaining appropriate therapies, educational support, and specialized interventions. While financial limitations and social isolation are also significant issues faced by these families, the primary concern often revolves around the challenges in accessing essential services for their children.

4. Which clean-catch urinalysis finding should raise the most concern for a child admitted to an urgent care center to rule out a urinary tract infection?

• A. 2+ white blood cells
• B. 1+ red blood cells
• C. Urine appearance: cloudy
• D. Specific gravity: 1.009

Correct answer: D

Rationale: A specific gravity of 1.009 is low, indicating diluted urine, which can be concerning in the context of a urinary tract infection. Diluted urine may suggest inadequate concentration due to increased fluid intake or impaired kidney function, which are important considerations in the assessment of a possible UTI.

5. The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

• A. Passive range-of-motion exercises to promote hip flexion
• B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
• C. Hourly vital signs and neurologic checks
• D. Elevate head of bed 30 degrees

Correct answer: A

Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.

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