Nursing Elites

1. When the working mother of a toddler is preparing to take her child home after a prolonged hospitalization, she asks the nurse what type of behavior she should expect to be displayed. What is the nurse’s most appropriate description of her child’s probable behavior?

• A. Excessively demanding behavior
• B. Hostile attitude toward the mother
• C. Cheerful, with shallow attachment behaviors
• D. Withdrawn, without emotional ties to the mother

Correct answer: A

Rationale: After a prolonged hospitalization, a toddler may exhibit excessively demanding behavior as they readjust to being home. This behavior can stem from the child feeling insecure or anxious about the changes in their environment. The child may seek extra attention and reassurance during this transition period. Choices B, C, and D are incorrect because hostility, shallowness in attachment, and withdrawal without emotional ties are less likely behaviors to be displayed by a toddler readjusting to home after a hospital stay.

2. A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What should the nurse recommend the parent to do?

• A. Administer syrup of ipecac.
• B. Call the poison control center.
• C. Take the child to the emergency department.
• D. Give the child bread dipped in milk to absorb the poison.

Correct answer: B

Rationale: In cases of potential poisoning, immediate guidance from professionals is crucial. Administering syrup of ipecac is no longer recommended routinely due to potential risks and lack of benefit. Taking the child to the emergency department is necessary in severe cases but may not always be the immediate action needed. Giving the child bread dipped in milk is not an appropriate method to manage poisoning and could potentially worsen the situation. Therefore, the most appropriate action for the nurse to recommend is to call the poison control center for expert advice on managing the situation.

3. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is crucial to avoid foods high in salt to manage symptoms and prevent complications. Excessive salt intake can lead to fluid retention and exacerbate edema, which are common issues in nephrotic syndrome. Encouraging a high-protein diet (Choice A) may put additional strain on the kidneys and worsen the condition. While protein restriction is sometimes needed, it is not the primary dietary concern in nephrotic syndrome. Similarly, a low-protein diet (Choice D) is not typically recommended as it may lead to malnutrition in children. Although a low-sodium diet (Choice C) may sound similar to avoiding foods high in salt, the emphasis should be on reducing salt intake specifically, rather than a generalized low-sodium approach.

4. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?

• A. Insulin
• B. Steroids
• C. Antibiotics
• D. Anticonvulsants

Correct answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.

5. A parent tells the nurse in the emergency department, 'My 3-year-old has had a fever for several days and has been vomiting.' After instituting ordered measures to reduce the fever, what nursing action is most important?

• A. Preventing shivering
• B. Restricting oral fluids
• C. Measuring output hourly
• D. Taking vital signs hourly

Correct answer: A

Rationale: Preventing shivering is crucial in this scenario as it can increase body temperature and counteract the effects of antipyretic measures aimed at reducing the fever. Shivering generates heat through muscle activity, which can elevate the body temperature. Restricting oral fluids (choice B) is inappropriate as maintaining hydration is vital, especially in cases of fever and vomiting. Measuring output hourly (choice C) and taking vital signs hourly (choice D) are important nursing actions but not the most critical in this case where preventing shivering takes precedence.

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