Nursing Elites

1. What is the most important information for the PN to reinforce with the parents when caring for a child diagnosed with acute rheumatic fever?

• A. Complete the full course of prescribed antibiotics.
• B. Ensure the child gets plenty of physical exercise.
• C. Keep the child on a low-sodium diet.
• D. Administer prescribed pain medications as needed.

Correct answer: A

Rationale: Completing the full course of antibiotics is crucial in the management of acute rheumatic fever as it helps prevent recurrence and complications. Antibiotics are essential in eradicating the underlying infection that triggers the autoimmune response leading to rheumatic fever. Reinforcing the importance of completing the prescribed antibiotic regimen is vital to ensure the child's recovery and prevent further health issues. Choices B, C, and D are not as critical as completing the antibiotic treatment. While physical exercise, a low-sodium diet, and pain management are important aspects of overall health, they are not the primary focus when managing acute rheumatic fever.

2. What is the most suitable toy for a 3-year-old boy receiving weekly chemotherapy treatment?

• A. Bouncy ball
• B. Coloring book with crayons
• C. Duck that squeaks
• D. Remote-controlled car

Correct answer: B

Rationale: A coloring book with crayons is the best choice as it is safe, engaging, and can provide a distraction during treatment without posing any safety risks. Coloring activities can help keep the child occupied, promote creativity, and offer a calming and therapeutic outlet during chemotherapy sessions.

3. During a well baby visit, the parents explain that a soft bulge appears in the groin of their 4-month-old son when he cries or strains during stooling. The infant is scheduled for surgical repair of the inguinal hernia in two weeks. What should the parent be instructed to do if the hernia becomes incarcerated prior to the surgery?

• A. Use a rectal thermometer to strain during stooling.
• B. Gently manipulate the hernia for reduction.
• C. Offer oral electrolyte fluids for comfort.
• D. Give acetaminophen or aspirin for crying.

Correct answer: B

Rationale: In the case of an incarcerated inguinal hernia, gentle manipulation can sometimes help in reducing it before surgery. This action should be taken cautiously and immediately followed by seeking medical attention. It is important to note that attempting reduction should be done by a healthcare professional, and parents should be advised to seek urgent medical care if the hernia becomes incarcerated. Using a rectal thermometer to strain during stooling (Choice A) is not the correct approach for an incarcerated hernia and can worsen the condition. Offering oral electrolyte fluids for comfort (Choice C) or giving acetaminophen or aspirin for crying (Choice D) are not appropriate interventions for an incarcerated hernia and may delay necessary medical treatment.

4. The healthcare provider is preparing to suture a 10-year-old child with a lacerated forehead. Both parents and a 12-year-old sibling are present at the child's bedside. Which instruction best supports family involvement?

• A. While waiting for the healthcare provider, only one visitor may stay with the child.
• B. All of you should leave while the healthcare provider sutures the child's forehead.
• C. It is best if the sibling goes to the waiting room until the suturing is completed.
• D. Please decide who will stay when the healthcare provider begins suturing.

Correct answer: D

Rationale: Involving the family members in deciding who will stay when the healthcare provider begins suturing supports family involvement and helps reduce anxiety for the child. This approach respects the family's dynamics and preferences, promoting a supportive environment during the procedure.

5. A mother brings her 2-year-old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2°F. Which intervention should the nurse implement?

• A. Ask the mother if the child has had a runny nose
• B. Cleanse purulent exudate from the affected ear canal
• C. Apply a topical antibiotic to the periauricular area
• D. Provide parent education to prevent recurrence

Correct answer: A

Rationale: In a child presenting with ear pain and fever, asking if the child has had a runny nose is crucial in assessing possible causes of an ear infection. Respiratory infections can lead to secondary ear infections, so exploring symptoms related to upper respiratory tract infections, like a runny nose, can help in the evaluation and management of the child's condition. Choice B is incorrect because cleansing purulent exudate should be done by a healthcare provider, not a nurse, and only if necessary. Choice C is incorrect because applying a topical antibiotic without proper evaluation and prescription is not within the nurse's scope of practice. Choice D is incorrect because while parent education may be necessary, addressing the immediate concern of evaluating possible causes of the ear pain and fever takes priority.

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