Nursing Elites

1. What clinical manifestation should be the most suggestive of acute appendicitis?

• A. Rebound tenderness
• B. Bright red or dark red rectal bleeding
• C. Abdominal pain that is relieved by eating
• D. Colicky, cramping abdominal pain around the umbilicus

Correct answer: D

Rationale: The correct answer is D: Colicky, cramping abdominal pain around the umbilicus. This type of pain is a common early sign of acute appendicitis. Rebound tenderness, choice A, is a later sign seen in the physical examination of a patient with appendicitis. Rectal bleeding, as described in choice B, is not typically associated with appendicitis. Abdominal pain that is relieved by eating, as mentioned in choice C, is more indicative of peptic ulcer disease rather than appendicitis.

2. What is the most frequent cause of hypovolemic shock in children?

• A. Sepsis
• B. Blood loss
• C. Anaphylaxis
• D. Heart failure

Correct answer: B

Rationale: Hypovolemic shock in children is most frequently caused by blood loss, which can result from trauma, surgery, or gastrointestinal bleeding. Sepsis and anaphylaxis can lead to different types of shock (septic and anaphylactic), and heart failure is related to cardiogenic shock.

3. Parents of a preschool child ask the nurse, "Should we set rules for our child as part of a discipline plan?" Which is an accurate response by the nurse?

• A. It is best to delay the punishment if a rule is broken.
• B. The child is too young for rules. At this age, unrestricted freedom is best.
• C. It is best to set the rules and reason with the child when the rules are broken.
• D. Set clear and reasonable rules and expect the same behavior regardless of the circumstances.

Correct answer: D

Rationale: Clear and reasonable rules provide structure and help children understand expectations, promoting consistent behavior and discipline.

4. The parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." What is the nurse's best action?

• A. Encourage the parent to verbalize feelings.
• B. Encourage the parent not to worry so much.
• C. Assess the parent for other signs of inadequate parenting.
• D. Reassure the parent that colic rarely lasts past age 9 months.

Correct answer: A

Rationale: Encouraging the parent to express their feelings is crucial in providing support and addressing the emotional challenges that colic can present. Reassuring the parent about the temporary nature of colic can also be helpful.

5. An awake, alert 4-year-old child has just arrived at the emergency department after an ingestion of aspirin at home. The practitioner has ordered activated charcoal. The nurse administers charcoal in which manner?

• A. Giving half of the solution and then repeating the other half in 1 hour
• B. Mixing with a flavorful beverage in an opaque container with a straw
• C. Serving it in a clear plastic cup so the child can see how much has been drunk
• D. Administering it through a nasogastric tube because the child will not drink it because of the taste

Correct answer: B

Rationale: Mixing activated charcoal with a flavorful beverage in an opaque container can help mask the taste and encourage the child to ingest it. Using an opaque container can prevent the child from seeing the unappealing appearance of the charcoal mixture, increasing compliance.

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