Nursing Elites

1. The nurses caring for a child are concerned about the child’s frequent requests for pain medication. During a team conference, a new nurse suggests they consider administering a placebo instead of the usual pain medication to see how the child responds. The team educates the nurse on why this is not appropriate and bases the decision on what knowledge?

• A. This practice is unjustified and unethical.
• B. This practice is effective in determining whether a child’s pain is real.
• C. The absence of a response to a placebo means the child’s pain has an organic basis.
• D. A positive response to a placebo will not occur if the child’s pain has an organic basis.

Correct answer: A

Rationale: The correct answer is A. The use of placebos without the patient’s consent is unethical and goes against the principles of beneficence and autonomy. Choice B is incorrect because using placebos does not provide reliable information about the presence or severity of the pain; it only indicates the response to the placebo itself. Choice C is wrong as the absence of a response to a placebo does not definitively mean that the child’s pain has an organic basis; there could be various reasons for the lack of response. Choice D is also incorrect as individuals may have a positive response to a placebo even if their pain has a significant organic cause. Therefore, the most appropriate response is A, emphasizing the ethical concerns surrounding the use of placebos without informed consent.

2. The nurse is teaching parents about potential causes of colic in infancy. Which should the nurse include in the teaching session?

• A. Overeating
• B. All are applicable
• C. Frequent burping
• D. Parental smoking

Correct answer: B

Rationale: Overeating, swallowing excessive air (leading to frequent burping), and parental smoking are known to contribute to colic in infants. Understimulation is not typically associated with colic.

3. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?

• A. Restlessness
• B. Distractibility
• C. Rectal discharge
• D. Intense perianal itching

Correct answer: D

Rationale: Intense perianal itching is the most common symptom of pinworm infection, especially at night when the female worms lay their eggs

4. According to Erikson’s developmental theory, toddlers need to be encouraged to become independent to successfully complete which developmental challenge?

• A. Trust vs. mistrust
• B. Industry vs. inferiority
• C. Autonomy vs. shame and doubt
• D. Initiative vs. guilt

Correct answer: C

Rationale: The correct answer is C: Autonomy vs. shame and doubt. Erikson's developmental stage for toddlers focuses on the conflict between developing a sense of independence (autonomy) and feelings of inadequacy (shame and doubt). Encouraging toddlers to explore their environment and make choices helps them build self-confidence and independence. Choices A, B, and D are incorrect because trust vs. mistrust relates to infancy, industry vs. inferiority is associated with school-age children, and initiative vs. guilt is linked to preschoolers.

5. A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. How should the nurse respond?

• A. Tell the parents they can stay in the hospital but not on the unit
• B. Read the rules and regulations of rooming in with the child
• C. Let the parents know they are allowed to stay with the child
• D. Explain to the parents why they cannot stay with the child

Correct answer: C

Rationale: The correct response is to let the parents know they are allowed to stay with the child. Allowing parents to stay with the child can help reduce the child's anxiety and provide comfort. Choice A is incorrect as the parents should be encouraged to stay with their child. Choice B is not the immediate response the nurse should provide. Choice D is inappropriate as it does not address the benefits and importance of parental presence for the child's well-being during hospitalization.

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