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 an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome?

• A. Assist the child in minimizing body movements.
• B. Change the child's position frequently.
• C. Maintain the child's bed flat.
• D. Keep edematous areas moist and covered.

Correct answer: B

Rationale: Changing the child's position frequently is essential for preventing respiratory tract infections and reducing pressure on delicate skin, which are common risks for edematous children with reduced mobility due to nephrotic syndrome. This intervention helps promote circulation and prevents complications associated with prolonged immobility.

3. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?

• A. Inflamed throat with exudate
• B. Purulent eye drainage
• C. Dry, hacking cough
• D. Koplik spots on buccal mucosa

Correct answer: C

Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.

4. Which statement best describes the recommended approach to increase participation as the focus of intervention with children and youth?

• A. Remediate areas of concern and the child's limitations
• B. Intervene with family and friends to interact differently with the child
• C. Promote the child's strengths and allow the child to accommodate challenges
• D. Evaluate the child's areas of competence and achievement, along with challenges

Correct answer: D

Rationale: The recommended approach to intervention with children and youth focuses on evaluating the child's areas of competence and achievement, along with challenges. By understanding the child's strengths and competencies, interventions can be tailored to build upon these existing positive attributes. This approach fosters a positive self-image and encourages further development by capitalizing on the child's strengths.

5. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

• A. I will make sure he gets his measles vaccine as soon as he gets home.
• B. He can stop taking his medication next week.
• C. I should check his urine for protein when he goes to the bathroom.
• D. He should eat a low-protein diet for the next few weeks.

Correct answer: C

Rationale: In nephrotic syndrome, monitoring urine for protein is essential as it helps track the child's condition. Checking urine for protein should be done as part of the discharge teaching to keep a record of the child's urinary proteins and to monitor the effectiveness of the treatment plan. It is crucial for parents to understand this aspect of care to ensure proper management of the child's condition. Choices A, B, and D are incorrect because getting a measles vaccine, stopping medication prematurely, and following a low-protein diet are not directly related to monitoring the child's condition and managing nephrotic syndrome.

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