Nursing Elites

1. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

• A. Female, multiple siblings, stable home life
• B. Male, high activity level, stressful home life
• C. Male, even-tempered, history of previous injuries
• D. Female, reacts negatively to new situations, no serious previous injuries

Correct answer: B

Rationale: A male child with a high activity level and a stressful home life has multiple risk factors for childhood injuries, requiring closer supervision and preventive measures.

2. What is the recommended position for a child after a tonsillectomy?

• A. Supine
• B. Prone
• C. Side-lying
• D. Fowler's position

Correct answer: C

Rationale: The correct answer is C: Side-lying. The side-lying position is recommended after a tonsillectomy to facilitate drainage of secretions and reduce the risk of aspiration. This position helps prevent blood from pooling in the back of the throat, decreasing the chance of bleeding postoperatively. Supine (lying face up), while commonly used in other situations, may not be ideal immediately after a tonsillectomy due to the risk of airway obstruction from blood clots. Prone (lying face down) is not recommended as it can hinder breathing and increase the risk of complications. Fowler's position (semi-sitting) is also not typically used after a tonsillectomy because it may cause discomfort and hinder proper drainage.

3. The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching?

• A. I can give my baby a ball of yarn to pull apart or different textured fabrics to feel
• B. I can use a music box and soft mobiles as appropriate play activities for my baby
• C. I should introduce a cup and spoon or push-pull toys for my baby at this age
• D. I do not have to worry about appropriate play activities at this age

Correct answer: B

Rationale: At 2 months, infants are most stimulated by visual and auditory activities, such as a music box or soft mobiles. These activities help in sensory development and are appropriate for this age.

4. Which pediatric disorder is associated with a 'boot-shaped' heart on a chest x-ray?

• A. Tetralogy of Fallot
• B. Transposition of the great arteries
• C. Coarctation of the aorta
• D. Ventricular septal defect

Correct answer: A

Rationale: The correct answer is A: Tetralogy of Fallot. Tetralogy of Fallot is often associated with a 'boot-shaped' heart appearance on a chest x-ray due to the characteristic heart anatomy in this condition. This appearance is caused by the combination of pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Choice B, Transposition of the great arteries, is incorrect because it presents with a 'egg-on-a-string' appearance on x-ray due to the abnormal position of the aorta and pulmonary artery. Choice C, Coarctation of the aorta, typically presents with rib notching on x-ray. Choice D, Ventricular septal defect, does not produce the 'boot-shaped' heart appearance seen in Tetralogy of Fallot.

5. What is the primary concern in a child with nephrotic syndrome?

• A. Hypotension
• B. Hyperkalemia
• C. Hyperlipidemia
• D. Hypocalcemia

Correct answer: C

Rationale: The correct answer is C: Hyperlipidemia. Children with nephrotic syndrome often present with hyperlipidemia due to altered lipid metabolism, making it a primary concern in these patients. Hypotension (choice A) is not a primary concern in nephrotic syndrome. Hyperkalemia (choice B) and hypocalcemia (choice D) are not typically associated with nephrotic syndrome and are less likely to be primary concerns in these patients.

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