Nursing Elites

1. When managing Kofi, a 3-year-old who is on admission and being managed for pneumonia, the nurse has just administered ibuprofen to a child with a temperature of 38.8°C. The nurse should also take which action?

• A. Plan to administer salicylate (aspirin) in 4 hours
• B. Remove excess clothing and blankets from the child
• C. Sponge the child with cold water
• D. Withhold oral fluids for 8 hours

Correct answer: B

Rationale: Removing excess clothing and blankets helps to promote heat loss and reduce fever. This intervention, along with the administration of antipyretics like ibuprofen, can aid in lowering the child's temperature and improving comfort during fever episodes.

2. Which of the following interventions is NOT appropriate for a hospitalized adolescent?

• A. Allow the adolescent to assist with procedures when possible.
• B. Encourage them to discuss their thoughts and feelings about the hospitalization.
• C. Encourage them to remain in the room throughout the hospitalization to ensure adequate rest periods.
• D. Encourage peer visitation.

Correct answer: C

Rationale: Encouraging the adolescent to remain in the room throughout the hospitalization may lead to social isolation, hinder the adolescent's emotional well-being, and impede their recovery. It is essential for adolescents to have social interaction, engage in meaningful conversations, and receive support from peers to cope with the stress of hospitalization. Choices A, B, and D are appropriate interventions as they promote involvement in care, emotional expression, and social support, which are beneficial for the adolescent's overall well-being during hospitalization.

3. Which of the following is not a clinical type of diarrhea?

• A. Acute diarrhea
• B. Bloody diarrhea
• C. Persistent diarrhea
• D. Secretory diarrhea

Correct answer: B

Rationale: Bloody diarrhea is not typically classified as a clinical type of diarrhea. The clinical types of diarrhea commonly include acute, persistent, and secretory diarrhea, which are characterized by different mechanisms and durations. Bloody diarrhea usually indicates the presence of blood in the stool, which can be a sign of various underlying conditions but is not a specific clinical type of diarrhea.

4. Which of the following is the MOST detrimental effect of gastric distention in infants and children?

• A. Tracheal rupture.
• B. Less effective chest compressions.
• C. Decreased ventilatory volume.
• D. Acute rupture of the diaphragm.

Correct answer: C

Rationale: Gastric distention in infants and children can lead to a decrease in ventilatory volume. This occurs because the distended stomach can limit the movement of the diaphragm, reducing its ability to contract and expand the chest cavity effectively. As a result, the amount of air entering and leaving the lungs is decreased, impacting ventilation. Tracheal rupture, acute rupture of the diaphragm, and less effective chest compressions are not typically associated with gastric distention.

5. When assessing a geriatric patient who has possibly experienced an acute ischemic stroke, which of the following questions would be MOST appropriate to ask?

• A. When did you first notice the symptoms?
• B. Do you have a history of high blood pressure?
• C. What medications do you take and why?
• D. Have you previously had a heart attack?

Correct answer: A

Rationale: The most appropriate question to ask when assessing a geriatric patient who may have experienced an acute ischemic stroke is when the symptoms were first noticed. This information is crucial for determining the time window for potential treatments like thrombolytic therapy, as prompt intervention is necessary for stroke management. Option B is not as relevant in the acute assessment of stroke, though important for overall health history. Option C is important but may not be as time-sensitive as determining symptom onset. Option D focuses on a different cardiac event, not directly related to the current concern of a possible stroke.

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