Nursing Elites

1. What information does the nurse include when teaching parents about nonpharmacologic strategies for pain management in children?

• A. May reduce pain perception.
• B. Make pharmacologic strategies unnecessary.
• C. Usually take too long to implement.
• D. Trick children into believing they do not have pain.

Correct answer: A

Rationale: The correct answer is A: 'May reduce pain perception.' When teaching parents about nonpharmacologic strategies for pain management in children, the nurse should include information that these techniques may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. It is important to note that nonpharmacologic techniques should be learned before the pain occurs, and it is beneficial to use both pharmacologic and nonpharmacologic measures for pain control. Choice B is incorrect because nonpharmacologic strategies do not make pharmacologic strategies unnecessary but rather complement them. Choice C is incorrect as nonpharmacologic techniques, when properly learned and applied, do not usually take too long to implement. Choice D is incorrect as the goal of nonpharmacologic strategies is not to trick children into believing they do not have pain, but to help them cope with and manage their pain effectively.

2. What is the typical presentation of pyloric stenosis in infants?

• A. Bilious vomiting
• B. Projectile vomiting
• C. Blood in stools
• D. Failure to thrive

Correct answer: B

Rationale: The correct answer is B: Projectile vomiting. Pyloric stenosis in infants typically presents with projectile vomiting, which is forceful and projective in nature. This occurs due to the obstruction at the pylorus, leading to the stomach being unable to empty properly. Choices A, C, and D are incorrect. Bilious vomiting is more commonly associated with intestinal obstruction, blood in stools can occur in conditions such as necrotizing enterocolitis or allergic colitis, and failure to thrive is a nonspecific finding that can be seen in various pediatric conditions.

3. A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?

• A. Flank pain rarely occurs in children with renal injuries.
• B. Few nonpenetrating injuries cause renal trauma in children.
• C. Kidneys are immobile, well protected, and rarely injured in children.
• D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.

Correct answer: D

Rationale: The amount of hematuria is not a reliable indicator of the severity of renal trauma, as even minor injuries can cause significant bleeding, while severe injuries may result in little or no visible blood. Renal trauma should be evaluated through imaging and clinical assessment.

4. What time frame has the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria, and pertussis (Tdap) vaccine?

• A. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
• B. During the first prenatal visit when pregnancy is confirmed
• C. The vaccine should be administered 24 hours prior to delivery
• D. This vaccine is only recommended during the first trimester

Correct answer: A

Rationale: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women without protection against pertussis should receive the Tdap vaccine ideally between 27 and 36 weeks of gestation or postpartum before discharge from the hospital. This timeframe allows for the development of antibodies in the mother to protect her and provide passive immunity to the infant. Administering the vaccine during the first trimester (Choice D) is not recommended as the optimal time is between 27 and 36 weeks. Choice B, during the first prenatal visit, is too early for optimal protection, and Choice C, 24 hours prior to delivery, does not provide enough time for the vaccine to be effective before birth.

5. What is the best indicator of fluid balance in a pediatric patient?

• A. Blood pressure
• B. Heart rate
• C. Weight
• D. Urine output

Correct answer: C

Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.

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