Nursing Elites

1. The nurse is teaching a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?

• A. Myelination continues into adolescence and beyond.
• B. The process occurs in a cephalocaudal (head-to-toe) pattern.
• C. Myelination decreases the speed of nerve impulses.
• D. Myelination decreases the specificity of nerve impulses.

Correct answer: B

Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect as myelination continues into adolescence and beyond, not just during childhood. Choice C is incorrect because myelination actually increases the speed of nerve impulses rather than decreasing it. Choice D is incorrect as myelination enhances the specificity of nerve impulses, making them more efficient and precise rather than less specific.

2. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

3. Where should the child admitted with injuries that may be related to abuse be placed?

• A. In a private room
• B. With an older, friendly child
• C. With a child of the same age
• D. In a room near the nurses’ desk

Correct answer: D

Rationale: The correct answer is to place the child in a room near the nurses’ desk. This placement allows for close monitoring and immediate intervention if needed, ensuring the safety and well-being of the child. Placing the child in a private room (Choice A) may limit visibility and monitoring. Putting the child with an older, friendly child (Choice B) or a child of the same age (Choice C) does not prioritize the necessary close monitoring and intervention that a child potentially experiencing abuse requires. Hence, placing the child in a room near the nurses’ desk is the most appropriate choice in this scenario.

4. During a nap, a 3-year-old hospitalized child wets the bed. How should the nurse respond?

• A. Ask the child to help with remaking the bed.
• B. Put clean sheets on the bed over a rubber sheet.
• C. Change the child’s clothes without discussing the incident.
• D. Explain that children should call the nurse when they need to go to the bathroom.

Correct answer: C

Rationale: When a 3-year-old hospitalized child wets the bed during a nap, the nurse should respond by changing the child's clothes without discussing the incident. This approach helps to maintain the child's dignity, avoid embarrassment, and reduce anxiety about bedwetting. Asking the child to help remake the bed (Choice A) may not be developmentally appropriate for a 3-year-old and could potentially lead to further distress. Putting clean sheets on the bed over a rubber sheet (Choice B) addresses the aftermath but does not directly address the child's needs and feelings. Explaining that children should call the nurse when they need to go to the bathroom (Choice D) may not be effective in this situation as the child may not have control over bedwetting during sleep.

5. A child with a diagnosis of asthma is being cared for by a nurse. What is an important nursing intervention?

• A. Administering bronchodilators
• B. Encouraging physical activity
• C. Monitoring oxygen saturation
• D. Providing nutritional support

Correct answer: A

Rationale: Administering bronchodilators is a crucial nursing intervention for a child with asthma because it helps to open the airways and ease breathing during an asthma attack. Bronchodilators are medications that work by relaxing the muscles around the airways, making it easier for the child to breathe. Encouraging physical activity may exacerbate asthma symptoms in some cases due to increased respiratory effort and exposure to triggers. Monitoring oxygen saturation is important but does not address the immediate need of opening the airways during an asthma episode. Providing nutritional support is essential for overall health but is not the primary intervention needed in managing an acute asthma exacerbation.

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