Nursing Elites

1. When checking the intravenous (IV) site on a child, the nurse should take which action?

• A. Look at the site.
• B. Ask the child if the site hurts.
• C. Look at the site while palpating the area.
• D. Take all the tape off, assess the site, and redress.

Correct answer: C

Rationale: Looking at and palpating the IV site helps assess for signs of infiltration or infection, such as swelling, redness, or pain. Simply looking or asking the child may miss subtle signs, and removing all the tape unnecessarily disrupts the site.

2. One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?

• A. Pain
• B. Rectal bleeding
• C. Perianal lesions
• D. Growth retardation

Correct answer: B

Rationale: Rectal bleeding is more commonly associated with ulcerative colitis (UC) than with Crohn disease (CD). While both conditions can cause abdominal pain and growth issues, bleeding is a hallmark of UC due to its superficial mucosal inflammation. Perianal lesions are more characteristic of CD, and growth retardation is typically not a direct clinical manifestation of either CD or UC.

3. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?

• A. Antibiotic treatment
• B. Adenoidectomy
• C. The insertion of tympanostomy (pressure equalizing) tubes
• D. Tonsillectomy

Correct answer: C

Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.

4. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

• A. Prevent the spread of infection.
• B. Monitor electrolyte balance.
• C. Prevent abdominal distention.
• D. Maintain accurate records of output.

Correct answer: C

Rationale: The primary purpose of an NG tube post-surgery for Hirschsprung disease is to prevent abdominal distention by decompressing the stomach and intestines. This helps prevent complications and promotes healing.

5. You are providing a home health care assessment for a very low-income mother with three young children under 5 who all appear to be at nutritional risk. Which program would you refer them to in an attempt to reduce the risk and safeguard the health of this family?

• A. Division of Maternal and Child Health
• B. Medicaid
• C. Supplemental Food Program for Women, Infants, and Children
• D. The State Children’s Health Insurance Program

Correct answer: C

Rationale: The correct answer is C, the Supplemental Food Program for Women, Infants, and Children (WIC). WIC provides nutritional assistance to low-income pregnant women, breastfeeding women, and children under 5. The Division of Maternal and Child Health (Choice A) focuses on promoting the health of mothers and children but does not provide direct nutritional assistance. Medicaid (Choice B) is a health insurance program for low-income individuals but does not specifically address nutritional needs. The State Children’s Health Insurance Program (Choice D) provides health insurance for children in low-income families but does not offer nutritional support like WIC does.

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