Nursing Elites

1. What does the Hib conjugate vaccine protect against?

• A. Bacterial meningitis
• B. Epiglottitis
• C. Bacterial pneumonia
• D. All Correct

Correct answer: D

Rationale: The Hib conjugate vaccine is crucial for protecting children from several severe infections caused by Haemophilus influenzae type b, including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. Therefore, all the provided options are correct. Bacterial meningitis, epiglottitis, and bacterial pneumonia are serious conditions that the Hib vaccine effectively prevents, making choice D the correct answer. Choices A, B, and C are incorrect when considered individually as the Hib vaccine does not protect against only one specific infection; rather, it provides immunity against multiple diseases caused by Haemophilus influenzae type b.

2. Several types of seizures can occur in neonates. What is characteristic of clonic seizures?

• A. Apnea
• B. Tremors
• C. Extension of all four limbs
• D. Jerking that cannot be stopped by flexion of the affected limb

Correct answer: D

Rationale: Clonic seizures are characterized by slow, rhythmic, jerking movements that cannot be stopped by flexion of the affected limb. Therefore, the correct characteristic of clonic seizures is option D. Option A, apnea, is not characteristic of clonic seizures. Option B, tremors, does not describe clonic seizures accurately. Option C, extension of all four limbs, is not a typical feature of clonic seizures but rather seen in tonic seizures.

3. A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the child’s prognosis is related to what factor?

• A. Admission blood pressure
• B. Creatinine clearance
• C. Amount of protein in urine
• D. Response to steroid therapy

Correct answer: D

Rationale: The prognosis for children with MCNS is closely related to their response to steroid therapy. A favorable response to steroids usually indicates a better prognosis, while poor response may require alternative treatments and can indicate a more complicated disease course.

4. What self-report pain rating scales can be used in children as young as 3 years of age?

• A. Poker Chip Tool
• B. Visual Analog Scale
• C. FACES Pain Rating Scale
• D. Word-Graphic Rating Scale

Correct answer: C

Rationale: The FACES Pain Rating Scale is suitable for children as young as 3 years of age. It uses facial expressions to depict different levels of pain, making it easy for young children to understand and use. The Poker Chip Tool is validated for children aged 4 and older who have a certain level of cognitive ability. The Visual Analog Scale is more appropriate for children aged 7 and above. The Word-Graphic Rating Scale, which uses descriptive words, is recommended for children in the age range of 4 to 17 years.

5. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?

• A. Initiating breast or bottle-feedings to stabilize the blood glucose level
• B. Maintaining pain management with an intravenous opioid
• C. Covering the intact bowel with a nonadherent dressing to prevent injury
• D. Performing immediate surgery

Correct answer: C

Rationale: The priority intervention for an infant with an omphalocele is to cover the intact bowel with a nonadherent dressing to protect the exposed organs and prevent infection. This intervention is crucial to prevent injury and maintain the infant's safety. Initiating feedings or maintaining pain management are not the immediate priorities in the care of an infant with an omphalocele. Performing immediate surgery may be required in the future, but initially, covering the bowel is the first critical step in management.

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