Nursing Elites

1. What is the most appropriate intervention for a child with suspected acute appendicitis?

• A. Administer antibiotics
• B. Apply heat to the abdomen
• C. Encourage oral fluids
• D. Prepare for surgery

Correct answer: D

Rationale: The correct answer is D: Prepare for surgery. Acute appendicitis is a surgical emergency that requires prompt removal of the appendix to prevent complications like rupture and peritonitis. Administering antibiotics (choice A) may be part of the treatment plan but should not delay surgical intervention. Applying heat to the abdomen (choice B) is not recommended as it can worsen the inflammation of the appendix. Encouraging oral fluids (choice C) is generally beneficial, but the priority in acute appendicitis is surgical intervention.

2. Which is a consequence of the physical punishment of children, such as spanking?

• A. The psychological impact is usually minimal.
• B. The child's development of reasoning increases.
• C. Children rarely become accustomed to spanking.
• D. Misbehavior is likely to occur when parents are not present.

Correct answer: D

Rationale: Physical punishment, such as spanking, may result in children misbehaving when parents are not present, as it does not teach appropriate behavior or self-regulation.

3. When the nurse interviews an adolescent, which is especially important?

• A. Focus the discussion on the peer group
• B. Allow an opportunity to express feelings
• C. Use the same type of language as the adolescent
• D. Emphasize that confidentiality will always be maintained

Correct answer: B

Rationale: Allowing adolescents to express their feelings helps them feel heard and supported, which is crucial for effective communication.

4. The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge?

• A. Most boys in the United States can be toilet trained at age 3 years.
• B. Training can begin when he has sufficient bladder capacity.
• C. Additional surgery may be necessary to achieve continence.
• D. They should begin now because he will require additional time.

Correct answer: B

Rationale: Toilet training should begin when the child has sufficient bladder capacity and control, which may be delayed in children who have undergone surgical repairs for conditions like bladder exstrophy. Premature training can lead to frustration and setbacks.

5. The nurse is educating a new nurse on the identification of pain in children. What does the nurse teach about physiologic measurements in children’s pain assessment?

• A. Not useful as the only indicator for pain
• B. Best indicator of pain in children of all ages
• C. Most valuable when children also report having pain
• D. Essential to determine whether a child is telling the truth about pain

Correct answer: A

Rationale: Physiologic manifestations of pain may vary considerably, so they do not provide a consistent measure of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or stabilize. Physiologic measurements are of limited value and must be viewed in the context of a pain rating scale, behavioral assessment, and parental report. When the child reports pain on an appropriate pain scale, the appropriate interventions should be used. Therefore, physiologic measurements are not considered a reliable standalone indicator for pain in children, making choice A the correct answer. Choice B is incorrect because physiologic measurements alone do not serve as the best indicator of pain. Choice C is incorrect as physiologic measurements are still limited even when children report pain. Choice D is incorrect as physiologic measurements are not primarily used to determine the truthfulness of a child's pain report.

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