Nursing Elites

1. Which inpatient pediatric patient would not be able to go to the playroom due to their physical condition?

• A. A 4-year-old with chickenpox
• B. A 12-year-old with a fractured femur
• C. A 7-year-old with new-onset diabetes mellitus
• D. A 10-year-old postoperative appendectomy

Correct answer: A

Rationale: The correct answer is A. A child with chickenpox should not go to the playroom due to being contagious, as the virus can easily spread to other children. Children with fractures (choice B), new-onset diabetes mellitus (choice C), or postoperative appendectomy (choice D) do not pose a risk of spreading an infectious disease, so they can safely go to the playroom.

2. At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?

• A. Developmentally appropriate toys
• B. Nutritious snacks served to the children
• C. Handwashing by providers after diaper changes
• D. Certified caregivers for each of the age groups at the facility

Correct answer: C

Rationale: Ensuring that providers practice proper handwashing after diaper changes is crucial in preventing the spread of infections and maintaining a hygienic environment for the infants.

3. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?

• A. The child will continue to sleep and be pain-free
• B. Parents cannot administer additional medication with the button
• C. The pump can deliver baseline and bolus dosages
• D. There is a high risk of overdose, so monitoring is done every 15 minutes

Correct answer: C

Rationale: PCA pumps are designed to deliver both a continuous baseline dose and patient-activated bolus doses, which can help manage pain effectively while minimizing the risk of overdose.

4. A preschool-age child is admitted to the pediatric unit for surgery. The parents request to stay with their child. How should the nurse respond?

• A. Tell the parents they can stay in the hospital but not on the unit
• B. Read the rules and regulations of rooming in with the child
• C. Let the parents know they are allowed to stay with the child
• D. Explain to the parents why they cannot stay with the child

Correct answer: C

Rationale: The correct response is to let the parents know they are allowed to stay with the child. Allowing parents to stay with the child can help reduce the child's anxiety and provide comfort. Choice A is incorrect as the parents should be encouraged to stay with their child. Choice B is not the immediate response the nurse should provide. Choice D is inappropriate as it does not address the benefits and importance of parental presence for the child's well-being during hospitalization.

5. What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

• A. Infarction of renal vessels
• B. Immune complex formation and glomerular deposition
• C. Bacterial endotoxin deposition on and destruction of glomeruli
• D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation

Correct answer: B

Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.

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