Nursing Elites

1. When caring for a child experiencing severe asthma symptoms, which medication should the practical nurse anticipate being administered first?

• A. Inhaled corticosteroids.
• B. Oral corticosteroids.
• C. Short-acting beta agonists.
• D. Leukotriene receptor antagonists.

Correct answer: C

Rationale: In the management of acute asthma exacerbations, the first-line medication for quick relief of bronchoconstriction is a short-acting beta agonist, such as albuterol. These medications help to rapidly open up the airways, providing immediate relief to the patient. Inhaled corticosteroids are more commonly used for long-term control of asthma symptoms, while oral corticosteroids and leukotriene receptor antagonists are often reserved for more severe or chronic cases. Therefore, in a child experiencing severe asthma symptoms, the practical nurse should anticipate the administration of short-acting beta agonists as the initial intervention to provide quick relief and improve breathing.

2. The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?

• A. Alternate glucose water with formula
• B. Mix the formula with rice cereal
• C. Add multivitamins with iron to the formula
• D. Use water to dilute the formula

Correct answer: B

Rationale: The correct instruction for promoting adequate nutrition in a 6-month-old infant with GERD is to mix the formula with rice cereal. This thickens the feed, reducing the risk of reflux, aiding in proper nutrition, and minimizing GERD symptoms. Choices A, C, and D are incorrect. Alternating glucose water with formula, adding multivitamins with iron to the formula, or diluting the formula with water are not recommended measures for promoting adequate nutrition in infants with GERD.

3. A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement?

• A. Obtain a specimen for blood cultures.
• B. Assess the CBC.
• C. Monitor the oral temperature every hour.
• D. Administer acetaminophen as prescribed.

Correct answer: A

Rationale: Obtaining a specimen for blood cultures is crucial in this situation as it helps identify the source of infection, if present, and guide appropriate treatment. This is important in a child with leukemia receiving chemotherapy to prevent potential complications and ensure timely intervention. Assessing the CBC may provide overall information on the child's condition but may not specifically identify a potential infection. Monitoring the oral temperature is important but obtaining blood cultures takes precedence in this scenario. Administering acetaminophen can help reduce fever but does not address the need to identify a possible infection source.

4. A 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?

• A. Describe the side-lying, knees to chest position that must be assumed during the procedure.
• B. Tell the child to expect loud clicking noises during the procedure that may be slightly annoying.
• C. Reassure the child that there will be no restrictions on activity after the procedure is completed.
• D. Explain that fluids cannot be taken for 8 hours before the procedure and for 4 hours after the procedure.

Correct answer: A

Rationale: The correct answer is A. Describing the side-lying, knees to chest position that must be assumed during the lumbar puncture procedure is essential as it helps the child understand what to expect, promotes cooperation, and reduces anxiety. This position is necessary for the procedure to be performed safely and effectively. Choice B is incorrect because mentioning loud clicking noises may increase the child's anxiety. Choice C is incorrect because there may be restrictions on activity after the procedure, depending on individual cases. Choice D is also incorrect as it provides information about fluid intake restrictions that are not directly related to the procedure itself.

5. The nurse is caring for a 10-year-old child who is scheduled for surgery to repair a fractured femur. The child’s parent expresses concern about the child being afraid of the surgery. What is the nurse’s best response?

• A. Children at this age are usually not afraid of surgery
• B. It’s normal for your child to feel scared. Let’s talk about what to expect
• C. You should talk to the surgeon about your child’s fear
• D. Don’t worry, your child will be fine

Correct answer: B

Rationale: Acknowledging the child’s fear and providing information about what to expect can help alleviate anxiety.

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