Nursing Elites

1. What information should be reinforced with the mother of a child with ringworm (Tinea)?

• A. Ringworm is not contagious.
• B. Tinea infections are indicative of poor hygiene and uncleanliness.
• C. Tinea infections are spread by direct and indirect contact.
• D. Ringworm often subsides spontaneously.

Correct answer: C

Rationale: The correct answer is C. Ringworm, a fungal infection, is highly contagious and can be spread by direct contact with infected individuals or animals and indirectly through contaminated objects. It is important for the mother to understand the modes of transmission to prevent the spread of the infection to others and to take necessary precautions to ensure proper treatment and containment of the condition. Choices A and D are incorrect because ringworm is indeed contagious, and it may not always subside spontaneously. Choice B is misleading as tinea infections are not solely indicative of poor hygiene; they can affect anyone, regardless of personal cleanliness.

2. When a 3-year-old boy asks a nurse why his baby sister is eating his mommy’s breast, how should the nurse respond? (Select the response that does not apply.)

• A. Remind him that his mother breastfed him too
• B. Clarify that breastfeeding is the mother’s choice
• C. Reassure the older brother that it does not hurt his mother
• D. Explain that newborns get milk from their mothers in this way

Correct answer: A

Rationale: In this scenario, the nurse should avoid reminding the older sibling about his own breastfeeding experience as it does not directly address the question posed by the boy. Providing simple explanations about breastfeeding and newborn feeding patterns helps the older sibling understand the natural process without bringing up personal experiences. Choice B is correct because clarifying that breastfeeding is the mother's choice helps the older sibling understand the concept of personal decisions. Choice C is appropriate as reassuring the older brother that it does not hurt his mother addresses a common concern children may have. Choice D is also suitable as it explains in simple terms how newborns receive milk from their mothers.

3. What information should be reinforced with the parents of a school-aged child about Reye's syndrome?

• A. Vaccinate your child before the age of 7 against Reye's syndrome.
• B. Keep the child at home for 2 days after the symptoms appear.
• C. Avoid giving any medication containing aspirin during a viral illness.
• D. Do not provide any citrus juices during a bacterial or viral illness.

Correct answer: C

Rationale: The correct answer is C: 'Avoid giving any medication containing aspirin during a viral illness.' It is crucial to advise parents to avoid giving any medication containing aspirin during a viral illness to prevent Reye's syndrome. Reye's syndrome is a rare but serious condition linked to the use of aspirin during viral illnesses in children and teenagers. Choices A, B, and D are incorrect because vaccinating against Reye's syndrome is not applicable as there is no specific vaccine for it, keeping the child at home for 2 days after symptoms appear is not a preventive measure for Reye's syndrome, and avoiding citrus juices is not directly related to the prevention of Reye's syndrome.

4. A 2-year-old child with heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin), the nurse obtains an apical heart rate of 128 bpm. What action should the nurse take?

• A. Determine the pulse deficit.
• B. Administer the scheduled dose.
• C. Calculate the safe dose range.
• D. Review the serum digoxin level.

Correct answer: B

Rationale: Administering the scheduled dose is appropriate in this scenario. The nurse obtained an apical heart rate of 128 bpm, which is within the expected range for a 2-year-old child. Therefore, there is no immediate concern to withhold the scheduled dose of digoxin. Determining the pulse deficit is not necessary as the heart rate is appropriate. Calculating the safe dose range is not needed as the current dose is within the therapeutic range. Reviewing the serum digoxin level may be indicated later for monitoring but is not urgent based on the heart rate assessment. Administering the scheduled dose of digoxin is the correct action at this time.

5. An adolescent female who comes to the school clinic is reluctant to confide her concerns to the practical nurse (PN). The PN tells the teen that confidentiality and privacy are maintained unless a life-threatening situation arises. Which principle supports the PN's response?

• A. The adolescent should be encouraged to seek help outside of the school clinic.
• B. Disclosures from the adolescent should be kept confidential.
• C. Honest information ensures establishing a trusting relationship.
• D. Minor adolescents should not be encouraged to disclose private concerns.

Correct answer: C

Rationale: The correct principle supporting the practical nurse's response is that honest information ensures establishing a trusting relationship. By assuring confidentiality and privacy to the adolescent unless there is a life-threatening situation, the practical nurse fosters an environment where the teen feels safe to share their concerns openly. This approach helps build trust, encouraging effective communication and support for the adolescent's well-being. Choices A, B, and D are incorrect because encouraging seeking help outside the school clinic, keeping disclosures confidential, and discouraging minor adolescents from sharing private concerns do not address the immediate need to build trust and ensure the well-being of the adolescent in a school setting.

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