Nursing Elites

1. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?

• A. Apply warm, moist compresses
• B. Apply pressure for at least 1 minute
• C. Elevate the area above the level of the heart
• D. Begin passive range-of-motion unless the pain is severe

Correct answer: C

Rationale: The correct supportive measure for the school nurse to use for a boy with hemophilia who fell on his arm during recess is to elevate the area above the level of the heart. Elevating the affected area helps reduce bleeding and swelling in a child with hemophilia until factor replacement therapy can be provided. Applying warm, moist compresses (Choice A) may worsen bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) is not recommended for hemophilia as it can lead to increased bleeding. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and further injury in a child with hemophilia.

2. What foods are appropriate for a 30-month-old toddler on a regular diet?

• A. Hamburger with bun and grapes
• B. Chicken fingers and french fries
• C. Hot dog with bun and potato chips
• D. Macaroni and cheese and Cheerios

Correct answer: D

Rationale: Macaroni and cheese and Cheerios are appropriate choices for a 30-month-old toddler on a regular diet as they provide a balance of carbohydrates and protein. Option A, hamburger with bun and grapes, may be difficult for a toddler to chew, and grapes pose a choking hazard. Option B, chicken fingers and french fries, are high in unhealthy fats and sodium. Option C, hot dog with bun and potato chips, are processed foods high in salt and unhealthy fats, not ideal for a toddler's diet.

3. What is the nurse’s priority intervention when preparing for admission of a child with acute laryngotracheobronchitis?

• A. Pad the side rails of the crib.
• B. Arrange for a quiet, cool room.
• C. Place a tracheotomy set at the bedside.
• D. Obtain a recliner so that a parent can stay.

Correct answer: C

Rationale: The correct answer is to place a tracheotomy set at the bedside. Acute laryngotracheobronchitis can cause airway obstruction, which may require an emergency tracheotomy. Having the tracheotomy set readily available ensures quick access in case of respiratory distress. Padding the side rails of the crib, arranging for a quiet, cool room, and obtaining a recliner for a parent are important aspects of care but are not the priority when managing a potentially life-threatening airway emergency.

4. When administering IV fluids to a dehydrated infant, what intervention is most important at this time?

• A. Continuing the prescribed flow rate
• B. Monitoring the intravenous drop rate
• C. Calculating the total necessary intake
• D. Maintaining the fluid at body temperature

Correct answer: B

Rationale: Monitoring the intravenous drop rate is the most crucial intervention when administering IV fluids to a dehydrated infant. This ensures that the correct amount of fluids is being delivered to the infant at the appropriate rate. While continuing the prescribed flow rate (Choice A) may be important, it does not allow for real-time adjustments that may be necessary during the infusion. Calculating the total necessary intake (Choice C) should have been determined before initiating IV therapy. Maintaining the fluid at body temperature (Choice D) is important for patient comfort but is not as critical as ensuring the proper administration of fluids.

5. A child is admitted with extensive burns. The nurse notes burns on the child’s lips and singed nasal hairs. The nurse should suspect that the child has a(n)

• A. chemical burn
• B. inhalation injury
• C. electrical burn
• D. hot-water scald

Correct answer: B

Rationale: Burns on the lips and singed nasal hairs are indicative of an inhalation injury. This suggests that the child has likely inhaled hot gases or smoke, leading to damage in the respiratory tract. Choice A, chemical burn, is incorrect because the symptoms described are more aligned with inhalation rather than direct contact with chemicals. Choice C, electrical burn, is incorrect as there are no mentions of contact with an electrical source. Choice D, hot-water scald, is also incorrect as the presentation of burns on the lips and singed nasal hairs is not characteristic of scald injuries.

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