Nursing Elites

1. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?

• A. Dislocated radial head
• B. Transient synovitis of the hip
• C. Osgood-Schlatter disease
• D. Scoliosis

Correct answer: C

Rationale: The correct answer is C: Osgood-Schlatter disease. This condition is a common overuse injury that affects the knee. Osgood-Schlatter disease typically occurs in children and adolescents who are involved in activities that require frequent running, jumping, and kicking. It is characterized by pain, swelling, and tenderness at the tibial tuberosity, where the patellar tendon inserts into the tibia. Choice A, Dislocated radial head, is not an overuse disorder but rather a form of elbow injury where the head of the radius bone is displaced from its normal position. Choice B, Transient synovitis of the hip, is a self-limiting condition that causes hip pain and limping in children. It is not typically considered an overuse disorder. Choice D, Scoliosis, is a condition characterized by an abnormal lateral curvature of the spine. While it may be related to certain activities or postures, it is not primarily classified as an overuse disorder.

2. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.

3. The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator?

• A. Lack of spontaneous movement
• B. Point tenderness
• C. Bruising
• D. Inability to bear weight

Correct answer: B

Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It is a localized tenderness experienced when pressure is applied to a specific area, suggesting a potential fracture. This tenderness is considered more specific to a fracture than other symptoms such as lack of spontaneous movement, bruising, or inability to bear weight. Lack of spontaneous movement and inability to bear weight can be present in various musculoskeletal injuries, while bruising may not always be immediate or specific to a fracture.

4. An infant is admitted to the neonatal intensive care unit (NICU) with exstrophy of the bladder. What covering should the nurse use to protect the exposed area?

• A. Loose diaper
• B. Dry gauze dressing
• C. Moist sterile dressing
• D. Petroleum jelly gauze pad

Correct answer: C

Rationale: A moist sterile dressing should be used to protect the exposed bladder tissue from infection and injury. Exstrophy of the bladder requires careful management to prevent complications such as infection. A loose diaper (Choice A) may not provide adequate protection or prevent infection. Dry gauze dressing (Choice B) may not be ideal as it could adhere to the exposed area and cause trauma upon removal. Petroleum jelly gauze pad (Choice D) may not be suitable as it can trap moisture and increase the risk of infection.

5. What is an important nursing consideration for a child with a diagnosis of juvenile idiopathic arthritis (JIA) being treated with methotrexate?

• A. Monitor liver function tests regularly
• B. Encourage regular exercise
• C. Provide high-calorie snacks
• D. Encourage frequent handwashing

Correct answer: A

Rationale: The correct answer is to monitor liver function tests regularly. Methotrexate, commonly used in JIA, can be hepatotoxic. Regular monitoring of liver function tests is crucial to detect any signs of liver damage early. While encouraging regular exercise (choice B) is generally beneficial for overall health, it is not directly related to methotrexate therapy. Providing high-calorie snacks (choice C) is not a necessary consideration in this context and can be misleading. Encouraging frequent handwashing (choice D) is important for infection control but is not specifically related to the medication methotrexate.

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