Nursing Elites

1. Which action should the nurse implement when taking an axillary temperature?

• A. Take the temperature through one layer of clothing
• B. Add a degree to the result when recording
• C. Place the tip of the thermometer under the arm in the center of the axilla
• D. Hold the child's arm away from the body while taking the temperature

Correct answer: C

Rationale: The correct technique involves placing the thermometer tip in the center of the axilla to ensure an accurate reading, with the arm held close to the body.

2. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

3. As the primary caregiver for a 5-month-old baby, according to Maslow’s hierarchy of basic needs, which intervention takes the highest priority?

• A. Feeding every four hours
• B. Protection from harm
• C. Providing stimulation
• D. Providing love

Correct answer: A

Rationale: The correct answer is A: Feeding every four hours. According to Maslow’s hierarchy of needs, physiological needs, such as food, water, and warmth, take the highest priority. Ensuring that the baby is fed regularly is crucial for survival and overall health. Choice B, protection from harm, relates more to safety needs which come after physiological needs. Choice C, providing stimulation, is associated with higher-level needs like belongingness and esteem. Choice D, providing love, corresponds to esteem and self-actualization needs, which are higher in the hierarchy than physiological needs.

4. 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.

5. How is family systems theory best described?

• A. The family is viewed as the sum of individual members
• B. A change in one family member cannot create a change in other members
• C. Individual family members are readily identified as the source of a problem
• D. When the family system is disrupted, change can occur at any point in the system

Correct answer: D

Rationale: Family systems theory views the family as a whole, where changes in one member affect the entire system, and changes can occur at any point within the system.

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