Nursing Elites

1. What is an important nursing intervention for a child with a newly inserted central venous catheter?

• A. Regularly monitor for signs of infection
• B. Administer intravenous fluids only as ordered
• C. Restrict the child's movement
• D. Perform daily dressing changes only

Correct answer: A

Rationale: Regularly monitoring for signs of infection is a critical nursing intervention for a child with a newly inserted central venous catheter. This intervention is essential to detect any early signs of infection, such as redness, swelling, or drainage at the catheter site, which can lead to serious complications like sepsis. Administering intravenous fluids as ordered is important but not the most crucial intervention for a newly inserted central venous catheter. Restricting the child's movement is unnecessary unless specified by the healthcare provider. Performing daily dressing changes alone is not sufficient to ensure the catheter's integrity and the child's safety; monitoring for signs of infection is key.

2. What is a primary intervention for a child with a suspected respiratory infection?

• A. Administer antiviral medications
• B. Increase fluid intake and rest
• C. Restrict all physical activity
• D. Provide high-dose vitamin supplements

Correct answer: B

Rationale: Increasing fluid intake and rest is a primary intervention for a child with a suspected respiratory infection because it helps support the body’s recovery and maintains hydration levels. Antiviral medications (Choice A) are only used for specific viral infections and are not routinely recommended for suspected respiratory infections. Restricting physical activity (Choice C) may be necessary in certain cases to prevent overexertion, but it is not a primary intervention. Providing high-dose vitamin supplements (Choice D) may support the immune system in general but is not a primary intervention for a suspected respiratory infection.

3. What should be a priority for a 4-year-old child with nephrosis?

• A. Impaired body image
• B. Skin impairment
• C. Nutritional deficit
• D. Injury

Correct answer: B

Rationale: The correct answer is B: Skin impairment. Skin care is a priority in nephrosis due to edema and increased risk of skin breakdown, requiring careful monitoring and management. While impaired body image (Choice A) can be a concern, it is not typically a priority in a 4-year-old with nephrosis. Nutritional deficit (Choice C) is important but addressing skin impairment takes precedence due to the immediate risk of complications related to skin breakdown. Injury (Choice D) is a general concern for children but is not the priority in a child with nephrosis.

4. Parents of a 6-month-old child, diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What should the nurse say?

• A. Are you sure your child has iron deficiency anemia?
• B. Maternal stores of iron are depleted at about 6 months.
• C. This anemia is caused by blood loss.
• D. The child may not have had it for a long time.

Correct answer: B

Rationale: The correct answer is B: 'Maternal stores of iron are depleted at about 6 months.' Iron deficiency anemia becomes apparent around 6 months of age when the infant's iron stores, primarily received from the mother during pregnancy, are depleted. This timing coincides with the introduction of solid foods, which may lack sufficient iron. Choices A, C, and D are incorrect because they do not address the specific reason why iron deficiency anemia is typically diagnosed around 6 months of age.

5. What should be assessed in an infant diagnosed with hypertrophic pyloric stenosis?

• A. Diarrhea after each feeding
• B. Gastric pain and vigorous crying
• C. Poor appetite due to poor sucking reflex
• D. An olive-shaped mass right of the midline

Correct answer: D

Rationale: In hypertrophic pyloric stenosis, an olive-shaped mass can often be palpated in the infant's abdomen, which is a hallmark sign of this condition. This mass is located in the right upper quadrant of the abdomen, right of the midline. Choices A, B, and C are incorrect because while infants with hypertrophic pyloric stenosis may experience vomiting (not diarrhea), gastric pain, and irritability, and have feeding difficulties, the key assessment finding specific to this condition is the palpable olive-shaped mass in the abdomen.

Similar Questions