Nursing Elites

1. What is the most appropriate action for a healthcare provider if a child presents with suspected meningitis?

• A. Administer antibiotics immediately
• B. Perform a lumbar puncture
• C. Isolate the child
• D. Obtain a complete blood count

Correct answer: C

Rationale: Isolating the child is a priority to prevent the spread of infection until meningitis is confirmed or ruled out. Meningitis, particularly bacterial, is highly contagious and can lead to outbreaks if not properly managed. Isolation and prompt treatment are critical in preventing serious complications. Administering antibiotics immediately without confirmation of the diagnosis can be harmful if the cause is viral or non-infectious. Performing a lumbar puncture is a diagnostic procedure that should be done by a healthcare provider but is not the initial action when suspecting meningitis. Obtaining a complete blood count may be part of the diagnostic workup but is not the most appropriate initial action in suspected meningitis.

2. Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?

• A. Blended
• B. Nuclear
• C. Extended
• D. Binuclear

Correct answer: C

Rationale: An extended family includes relatives such as grandparents, aunts, uncles, and other extended family members living together, beyond just the nuclear family unit.

3. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?

• A. Give only an opioid analgesic at this time.
• B. Increase the dosage of analgesic until the child is adequately sedated.
• C. Plan a preventive schedule of pain medication around the clock.
• D. Give the child a clock and explain when they can have pain medications.

Correct answer: C

Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.

4. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?

• A. The child will continue to sleep and be pain-free
• B. Parents cannot administer additional medication with the button
• C. The pump can deliver baseline and bolus dosages
• D. There is a high risk of overdose, so monitoring is done every 15 minutes

Correct answer: C

Rationale: PCA pumps are designed to deliver both a continuous baseline dose and patient-activated bolus doses, which can help manage pain effectively while minimizing the risk of overdose.

5. The nurse is providing education to the parent of a child with Beta-thalassemia. Which risk factors about the condition should the nurse include in the teaching?

• A. Hypertrophy of the thyroid
• B. Polycythemia vera
• C. Thrombocytopenia
• D. Chronic hypoxia and iron overload

Correct answer: D

Rationale: The correct answer is D: Chronic hypoxia and iron overload. Children with Beta-thalassemia often suffer from chronic hypoxia due to ineffective erythropoiesis and require frequent blood transfusions, leading to iron overload. These complications must be managed to prevent organ damage. Choices A, B, and C are incorrect. Hypertrophy of the thyroid, polycythemia vera, and thrombocytopenia are not direct risk factors associated with Beta-thalassemia. Therefore, they should not be included in the teaching regarding this condition.

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