Nursing Elites

1. The practical nurse is caring for a child with suspected appendicitis. Which assessment finding should be reported to the healthcare provider immediately?

• A. Nausea and vomiting.
• B. Sudden relief of pain.
• C. Low-grade fever.
• D. Rebound tenderness.

Correct answer: B

Rationale: Sudden relief of pain in a child with suspected appendicitis should be reported immediately as it may indicate a rupture of the appendix, which is a medical emergency. Sudden relief of pain is concerning because it can be a sign of a perforated appendix, leading to peritonitis and sepsis.

2. What information should a nurse discuss with the mother of a 2-year-old girl who is drinking sweetened soda from her bottle?

• A. Encouraging 2-word phrases in speech development for a 2-year-old
• B. Explaining the association between drinking soda and dental caries
• C. Discussing the link between drinking soda and childhood obesity
• D. Emphasizing the importance of toddlers sleeping 10 hours a night

Correct answer: B

Rationale: The correct answer is explaining the association between drinking soda and dental caries. Soda consumption can lead to tooth decay and cavities, so it is crucial to educate the mother about this to prevent dental issues in the child.

3. A 3-year-old child is brought to the clinic by the parents who are concerned that the child is not yet potty trained. What is the nurse’s best response?

• A. Most children are potty trained by this age, so you should not be concerned
• B. Every child develops at their own pace. Let’s discuss some strategies to help
• C. Your child may need to be evaluated for developmental delays
• D. It’s best to force your child to use the potty to encourage training

Correct answer: B

Rationale: The correct answer is B because it is important to acknowledge that children develop at different rates. By offering support and discussing strategies for potty training, the nurse can provide the necessary guidance without causing unnecessary concern or pressure on the parents. Choice A is incorrect because it dismisses the parents' concerns. Choice C is incorrect because jumping to the conclusion of developmental delays without further assessment or discussion can cause undue anxiety. Choice D is incorrect because forcing a child to use the potty can lead to resistance and negative associations with potty training.

4. A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment of the girl is most important for the nurse to obtain?

• A. Understanding of the quality control process used to troubleshoot the pump
• B. Interpretation of fingerstick glucose levels that influence diet selections
• C. Knowledge of her glycosylated hemoglobin A1c levels for the past year
• D. Ability to perform the pump for basal insulin with mealtime boluses

Correct answer: A

Rationale: In a patient transitioning to an insulin pump, understanding the quality control process to troubleshoot the pump is crucial for ensuring proper and safe management of diabetes. This knowledge enables the individual to identify and address any issues that may arise with the pump, helping maintain optimal glycemic control and prevent complications. Choices B, C, and D, although important in diabetes management, are not as critical as ensuring the correct understanding of troubleshooting the pump, which directly impacts the girl's ability to effectively use the pump for insulin delivery.

5. The healthcare provider is preparing to administer a vaccine to a 5-year-old child. The child is visibly anxious and asks if the shot will hurt. What is the healthcare provider’s best response?

• A. It might hurt a little, but it will be over quickly
• B. It won't hurt at all, don't worry
• C. You're a big kid now, and big kids don't cry
• D. If you don't think about it, it won't hurt

Correct answer: A

Rationale: When a child expresses fear or anxiety about receiving a vaccination, it is essential for the healthcare provider to provide honest and reassuring information. Choice A acknowledges the potential for some discomfort but also reassures the child that it will be over quickly. This response validates the child's feelings while also preparing them for the procedure. Choices B, C, and D either provide false reassurance, dismiss the child's feelings, or suggest avoidance, which are not appropriate responses in this situation.

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