Nursing Elites

1. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?

• A. “Attempt to distract the child by offering a toy to the child.”
• B. “Say nothing and allow the tantrum to continue until it ends.”
• C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
• D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”

Correct answer: B

Rationale: The nurse's best response is to allow the tantrum to continue until it ends without giving in to the child's demands. By not rewarding the child with the desired item during a tantrum, the child learns that this behavior is not effective in getting what they want. Offering a toy to distract the child (Choice A) may reinforce the idea that tantrums lead to rewards. Leaving the child with a babysitter (Choice C) does not address the issue at hand, which is teaching the child appropriate behavior in public places. Giving the child the item temporarily (Choice D) may encourage the child to have tantrums in the future to obtain desired items.

2. During postoperative care for a child who has had a tonsillectomy, what is an important nursing intervention?

• A. Encouraging deep breathing exercises
• B. Encouraging the child to eat
• C. Administering antibiotics
• D. Applying ice to the throat

Correct answer: C

Rationale: Administering antibiotics is crucial post-tonsillectomy to prevent infection, as the surgical site is susceptible to bacterial growth. Encouraging deep breathing exercises can also be beneficial for lung expansion and preventing respiratory complications. However, administering antibiotics takes precedence as it directly addresses the risk of infection. Encouraging the child to eat may not be appropriate immediately post-tonsillectomy due to the risk of throat irritation and potential discomfort. Applying ice to the throat is typically not recommended after a tonsillectomy, as it may constrict blood vessels and hinder the healing process.

3. A child is being assessed for suspected intussusception. What clinical manifestation is the healthcare provider likely to observe?

• A. Projectile vomiting
• B. Currant jelly stools
• C. Abdominal distension
• D. Constipation

Correct answer: C

Rationale: The correct clinical manifestation the healthcare provider is likely to observe in a child with suspected intussusception is abdominal distension. Intussusception involves one portion of the intestine telescoping into another, causing obstruction. Abdominal distension is a common symptom due to the obstruction and buildup of gas and fluid in the affected area. While projectile vomiting can occur, it is not as specific to intussusception as abdominal distension. Currant jelly stools, which are stools containing blood and mucus, are a classic sign of intussusception but are not a clinical manifestation observable on assessment. Constipation is not typically associated with intussusception, as this condition often presents with symptoms of bowel obstruction rather than constipation.

4. A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?

• A. We should give this drug after he eats something.
• B. We need to watch carefully for possible infections.
• C. The drug should not be stopped abruptly.
• D. He might experience weight gain with this drug.

Correct answer: A

Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.

5. Which of the following findings would indicate altered mental status in a small child?

• A. Recognizing the parents
• B. Showing fright at the EMT-B's presence
• C. Displaying a lack of attention to the EMT-B's presence
• D. Maintaining consistent eye contact with the EMT-B

Correct answer: C

Rationale: In a small child, displaying a lack of attention to the EMT-B's presence would indicate altered mental status. This behavior suggests a diminished level of consciousness or awareness, which is concerning. Recognizing the parents (Choice A) is a normal and expected behavior for a child. Showing fright at the EMT-B's presence (Choice B) may indicate fear or anxiety but not necessarily altered mental status. Maintaining consistent eye contact with the EMT-B (Choice D) may indicate engagement or curiosity rather than altered mental status.

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