Nursing Elites

1. Which best describes signs and symptoms as part of a nursing diagnosis?

• A. Description of potential risk factors
• B. Identification of actual health problems
• C. Human response to state of illness or health
• D. Cues and clusters derived from patient assessment

Correct answer: D

Rationale: Signs and symptoms are cues and clusters derived from patient assessments that are used to form a nursing diagnosis, guiding the development of a care plan.

2. What should the nurse include in the discharge instructions for the parents of an infant diagnosed with acute otitis media?

• A. Keep the baby in an elevated position during sleep
• B. Administer an antibiotic
• C. Place the baby to sleep with a bottle
• D. Administer acetaminophen (Tylenol) to relieve discomfort

Correct answer: D

Rationale: Acetaminophen (Tylenol) is recommended to help relieve the discomfort associated with acute otitis media, such as pain and fever. Elevating the baby's head during sleep can also help with drainage and relieve pressure, making choice A incorrect. Administering an antibiotic may be necessary for bacterial otitis media but is not usually the first-line treatment for acute otitis media, so choice B is incorrect. Placing the baby to sleep with a bottle can increase the risk of ear infections due to the pooling of milk around the Eustachian tube, so choice C is incorrect.

3. During the nurse’s initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. What action should the nurse take?

• A. Reassess the child in 15 minutes to see if the pain rating has changed
• B. Administer the prescribed analgesic
• C. Do nothing since the child appears to be resting
• D. Ask the child’s parents if they think the child is hurting

Correct answer: B

Rationale: Pain management should be based on the child’s report of pain, regardless of their activity level. Administering the prescribed analgesic is the appropriate action. Reassessing the child in 15 minutes without providing immediate pain relief may not be in the child's best interest. Doing nothing since the child appears to be resting may lead to inadequate pain management. Asking the child’s parents if they think the child is hurting does not replace the need for direct assessment and intervention by the nurse.

4. Which teaching point should the nurse include when providing education to an adolescent client who participates in soccer regarding the plan of care for diabetes mellitus?

• A. Decreased food intake
• B. Increased doses of insulin
• C. Increased food intake
• D. Decreased doses of insulin

Correct answer: C

Rationale: The correct teaching point the nurse should include is to advise the adolescent client who participates in soccer to increase food intake. Physical activity increases glucose utilization, so adolescents with diabetes need to consume additional carbohydrates to prevent hypoglycemia during and after exercise. Choice A (Decreased food intake) is incorrect because the adolescent needs extra carbohydrates to support the increased physical activity. Choice B (Increased doses of insulin) is incorrect as the focus should be on adjusting food intake rather than insulin doses. Choice D (Decreased doses of insulin) is also incorrect as the insulin doses should be adjusted based on the increased food intake and physical activity level.

5. When describing play by the school-aged child to a group of nursing students, the instructor would emphasize the need for which of the following?

• A. Recreation
• B. Ritualism
• C. Physical activity
• D. Rules

Correct answer: D

Rationale: The correct answer is D: Rules. When discussing play in school-aged children, rules are essential as they help in structuring games and social interactions. Rules provide a framework for play, ensuring fairness and cooperation among children. Choice A, recreation, is too broad and doesn't specifically address the importance of rules in play. Choice B, ritualism, is unrelated to the concept of play in school-aged children. Choice C, physical activity, is important for overall health but doesn't capture the specific aspect of rules that are crucial in the play of school-aged children.

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