Nursing Elites

1. When planning care for a pediatric client diagnosed with bacterial meningitis, what is the priority nursing diagnosis?

• A. Impaired Gas Exchange
• B. Risk for Infection
• C. Anxiety (parental)
• D. Acute Pain

Correct answer: A

Rationale: The priority nursing diagnosis when caring for a pediatric client with bacterial meningitis is 'Impaired Gas Exchange.' This diagnosis takes precedence due to the potential for respiratory complications associated with the condition. Bacterial meningitis can lead to increased intracranial pressure, compromising the child's ability to ventilate adequately. Therefore, monitoring and addressing any signs of respiratory distress are crucial in the care of these patients.

2. What is it called when the therapist adjusts the difficulty level of an activity to match the child's abilities by bringing a toy closer for them to successfully reach and grasp during therapy?

• A. Compensating
• B. Adapting
• C. Grading
• D. Modifying

Correct answer: C

Rationale: The correct answer is C: Grading. Grading involves adjusting the difficulty level of an activity to match the child's abilities. Bringing a toy closer for easier reach is an example of grading in therapy, helping the child succeed in reaching and grasping the toy within their current capabilities. Choice A, Compensating, implies making up for a deficit, which is not the case here. Choice B, Adapting, suggests changing the activity itself, not just the difficulty level. Choice D, Modifying, indicates altering the toy or the task itself, rather than adjusting the task's difficulty level.

3. When evaluating infants and young children in early intervention services, which of the following is recommended?

• A. Gain information from family, caregivers, professionals, and the child to create a total picture of the child's strengths and challenges
• B. Report test scores and therapist observations rather than parent reports
• C. Identify the areas of concern, weaknesses, and deficits to best address the child's and family's needs
• D. Observe the child in one setting with objective data from professionals

Correct answer: A

Rationale: When evaluating infants and young children in early intervention services, it is crucial to gather information from multiple sources, including family, caregivers, professionals, and the child. This holistic approach helps create a comprehensive understanding of the child's strengths and challenges, leading to a more effective intervention plan.

4. What is the corrected age of a child born at 30 weeks gestation on May 2, 2014, who is being tested on August 5, 2014?

• A. 3 months
• B. 2 weeks
• C. 2.6 months
• D. 4 weeks

Correct answer: B

Rationale: To calculate the corrected age of a premature child, you need to adjust for the weeks of prematurity. In this case, the child was born at 30 weeks gestation. From May 2, 2014, to August 5, 2014, is a span of 14 weeks. Subtracting the 30 weeks of gestation from the total time passed (14 weeks) gives the corrected age, which is 14 - 30 = -16 weeks. Since negative weeks are not relevant here, the corrected age is 0 weeks, which is equivalent to 2 weeks. Choice A is incorrect because 3 months is not the correct adjustment for the given scenario. Choice C is incorrect as it provides a fractional value for age, which is not practical in this context. Choice D is incorrect as 4 weeks does not account for the weeks of prematurity.

5. During a physical assessment of a hospitalized 5-year-old child, the healthcare provider notes that the foreskin has been retracted and is very tight on the shaft of the penis; they are unable to return it over the head of the penis. What action should the healthcare provider implement?

• A. Forcibly push the foreskin down over the head of the penis.
• B. Place a warm compress on the penis.
• C. Notify the healthcare provider in charge.
• D. Wait a few hours and try again.

Correct answer: C

Rationale: The correct action is to notify the healthcare provider in charge of this occurrence of paraphimosis. Paraphimosis is a urologic emergency where the foreskin is retracted and becomes tight, potentially impeding blood flow to the penis. It is crucial to seek medical intervention promptly to prevent complications.

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