Nursing Elites

1. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

• A. Send the child to his or her room if the child has one.
• B. A general rule for length of time is 1 hour per year of age.
• C. Select an area that is safe and nonstimulating, such as a hallway.
• D. If the child cries, refuses, or is more disruptive, try another approach.

Correct answer: C

Rationale: Time-outs should be in a safe, nonstimulating area, with the length typically being 1 minute per year of the child's age, not 1 hour.

2. The parents of an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?

• A. Your infant will not need any subsequent follow-up care
• B. Your infant will only need to be evaluated by an audiologist
• C. Your infant will only need follow-up with a speech pathologist
• D. Your infant will need follow-up with audiologists and orthodontists

Correct answer: D

Rationale: After cleft palate repair, the child will need ongoing follow-up with audiologists, speech pathologists, and orthodontists to monitor hearing, speech development, and dental alignment.

3. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?

• A. An emergency laparotomy is very likely.
• B. The location needs to be confirmed by radiographic examination.
• C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
• D. Careful observation is essential because an ingested battery cannot be accurately detected.

Correct answer: B

Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.

4. At what point in the hospitalization of the pediatric patient should discharge planning and teaching begin?

• A. Post-operatively
• B. Right when the patient is being discharged with the parents and support members present
• C. On the morning that the patient is scheduled to go home
• D. On admission

Correct answer: D

Rationale: Discharge planning should begin on admission to ensure that all necessary teaching and preparations are completed in a timely manner. Starting discharge planning early allows for a comprehensive assessment of the patient's needs, coordination with the healthcare team, and adequate time for patient and family education. Choice A, post-operatively, is too late in the process and may lead to rushed planning. Choice B, right at discharge, may not allow enough time for thorough preparation. Choice C, on the morning of discharge, also does not provide sufficient time for effective planning and education.

5. The parents of a school-age child ask the nurse if she thinks that their child has attention deficit hyperactivity disorder (ADHD). Which statement regarding the child’s behavior at school is most indicative of ADHD?

• A. He finishes his work on time in order to go to recess.
• B. He occasionally gets into trouble for talking.
• C. He enjoys math but does not like reading.
• D. He cannot sit still in his seat and constantly moves his legs.

Correct answer: D

Rationale: The most indicative behavior of ADHD is the inability to sit still and constant movement, known as hyperactivity. This behavior is a hallmark symptom of ADHD, making option D the correct choice. Options A, B, and C do not specifically reflect the characteristic hyperactivity associated with ADHD, making them less indicative of the disorder. While option B suggests impulsivity, it is not as specific to ADHD as the hyperactivity described in option D.

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