Nursing Elites

1. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?

• A. On the lower jaw
• B. Side of the tongue
• C. Against the soft palate
• D. Center back area of the tongue

Correct answer: B

Rationale: The side of the tongue is the appropriate place for a tongue blade to avoid triggering the gag reflex during assessment of the mouth and throat.

2. One of the most critical needs of the infant is control of body temperature. The nurse caring for a newborn warms all equipment that comes in direct contact with the newborn to help prevent which type of heat loss?

• A. Convection
• B. Evaporation
• C. Conduction
• D. Radiation

Correct answer: C

Rationale: The correct answer is Conduction (choice C). Conduction heat loss occurs when the newborn’s skin comes into direct contact with a cooler surface, so warming equipment helps prevent this. Choice A, Convection, is the transfer of heat through air or water currents, not direct contact. Choice B, Evaporation, is the loss of heat through moisture on the skin evaporating, not direct contact. Choice D, Radiation, is the transfer of heat in the form of waves or particles, not direct contact.

3. The nurses caring for a child are concerned about the child’s frequent requests for pain medication. During a team conference, a new nurse suggests they consider administering a placebo instead of the usual pain medication to see how the child responds. The team educates the nurse on why this is not appropriate and bases the decision on what knowledge?

• A. This practice is unjustified and unethical.
• B. This practice is effective in determining whether a child’s pain is real.
• C. The absence of a response to a placebo means the child’s pain has an organic basis.
• D. A positive response to a placebo will not occur if the child’s pain has an organic basis.

Correct answer: A

Rationale: The correct answer is A. The use of placebos without the patient’s consent is unethical and goes against the principles of beneficence and autonomy. Choice B is incorrect because using placebos does not provide reliable information about the presence or severity of the pain; it only indicates the response to the placebo itself. Choice C is wrong as the absence of a response to a placebo does not definitively mean that the child’s pain has an organic basis; there could be various reasons for the lack of response. Choice D is also incorrect as individuals may have a positive response to a placebo even if their pain has a significant organic cause. Therefore, the most appropriate response is A, emphasizing the ethical concerns surrounding the use of placebos without informed consent.

4. The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?

• A. Preschool
• B. Young school age
• C. Middle school age
• D. Adolescent

Correct answer: A

Rationale: Preschool children are at higher risk for injury due to magical and egocentric thinking, which can lead to misjudgments about their abilities and dangers.

5. What is the most appropriate action for a child with epistaxis?

• A. Have the child lie flat
• B. Pinch the nose and lean forward
• C. Apply a warm compress to the nose
• D. Encourage deep breathing

Correct answer: B

Rationale: The most appropriate action for a child with epistaxis is to pinch the nose and lean forward. This technique helps stop the bleeding and prevent aspiration of blood. By applying pressure to the bleeding vessels and allowing the blood to drain out of the nostrils instead of being swallowed, the risk of nausea and airway obstruction is reduced. Having the child lie flat (Choice A) may lead to blood flowing down the throat, causing potential choking. Applying a warm compress (Choice C) is not typically recommended for epistaxis as cold compresses are more effective. Encouraging deep breathing (Choice D) is not directly related to managing epistaxis.

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