Nursing Elites

1. Which is the appropriate intervention when providing care to a child diagnosed with nephrotic syndrome, who is edematous and on bed rest?

• A. Monitor blood pressure every 30 minutes.
• B. Reposition every 2 hours.
• C. Limit visitors.
• D. Encourage fluids.

Correct answer: B

Rationale: Repositioning every 2 hours is crucial in preventing skin breakdown in an edematous child on bed rest. This intervention helps redistribute pressure and maintain skin integrity, reducing the risk of pressure ulcers. It is an essential part of care for patients with limited mobility to ensure their comfort and prevent complications related to immobility.

2. In caring for an adolescent with severe abdominal pain due to appendicitis, where should the nurse identify as McBurney's point?

• A. Right lower quadrant
• B. Left lower quadrant
• C. Right upper quadrant
• D. Left upper quadrant

Correct answer: A

Rationale: McBurney's point is located in the right lower quadrant of the abdomen, specifically between the umbilicus and the anterior iliac crest. This point is significant in diagnosing appendicitis, as tenderness at McBurney's point is a classic sign of appendicitis and indicates inflammation near the appendix. Therefore, the correct answer is the 'Right lower quadrant.' Choices B, C, and D are incorrect because McBurney's point is not located in the left lower quadrant, right upper quadrant, or left upper quadrant of the abdomen.

3. During a vaso-occlusive crisis in sickle cell anemia, what action is crucial for a nurse to take?

• A. Administer meperidine for pain.
• B. Apply cold compresses to the child's joints.
• C. Limit the child's fluid intake.
• D. Maintain bed rest for the child.

Correct answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing. Administering meperidine for pain (Choice A) is not recommended due to the risk of normeperidine accumulation and potential neurotoxicity. Applying cold compresses (Choice B) may cause vasoconstriction, worsening the vaso-occlusive crisis. Limiting fluid intake (Choice C) is not appropriate as adequate hydration is essential to prevent dehydration and maintain blood flow.

4. Which level nursery classifications are housed in institutions that can provide on-site surgical repair of serious congenital or acquired malformations?

• A. Level III
• B. Level I
• C. Level IV
• D. Level II

Correct answer: C

Rationale: The correct answer is C: Level IV. Level IV nurseries are equipped to provide the highest level of care, including complex surgical interventions for serious congenital or acquired malformations. These nurseries have the necessary resources and expertise to manage critical cases effectively. Choice A: Level III nurseries provide advanced care for moderately ill newborns but may not have the capacity for on-site surgical repair of serious malformations. Choice B: Level I nurseries offer basic care for healthy newborns and those with minor issues, lacking the resources for surgical interventions. Choice D: Level II nurseries can manage moderately ill newborns but may not have the capability for complex surgical interventions like Level IV nurseries.

5. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?

• A. Inflamed throat with exudate
• B. Purulent eye drainage
• C. Dry, hacking cough
• D. Koplik spots on buccal mucosa

Correct answer: C

Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.

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