Nursing Elites

1. Which medication should the nurse expect to administer to a child with an acute sickle cell pain crisis?

• A. Meperidine (Demerol)
• B. Morphine
• C. Acetaminophen (Tylenol)
• D. Ibuprofen (Motrin)

Correct answer: B

Rationale: In the management of acute sickle cell pain crisis in children, morphine is the preferred medication due to its effectiveness in providing pain relief. Meperidine (Demerol) is less commonly used in this scenario because of its potential for neurotoxicity with repeated doses. Acetaminophen (Tylenol) and Ibuprofen (Motrin) are not typically sufficient for managing the severe pain associated with sickle cell crises and are not the first-line treatment options.

2. The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which?

• A. The infant responds to his own name.
• B. The infant localizes sounds by turning his head directly to the sound.
• C. The infant turns his head to the side when sound is made at the level of the ear.
• D. The infant locates sound by turning his head to the side and then looking up or down.

Correct answer: C

Rationale: By 10 weeks, infants typically turn their heads to the side to locate the source of a sound made at ear level.

3. A 12-year-old child had an appendectomy 18 hours ago. The nurse is monitoring the child for pain control. Which of the following tools is most appropriate for assessing the child’s pain?

• A. FLACC scale
• B. Numeric scale
• C. NIPS scale
• D. FACES scale

Correct answer: B

Rationale: The Numeric scale is the most appropriate tool for assessing pain in older children, like a 12-year-old, as they can comprehend and use numbers to indicate their pain levels accurately. The FLACC scale is typically used for nonverbal or preverbal children. The NIPS scale is designed for neonates and infants. The FACES scale is more commonly used in younger children who may have difficulty expressing their pain in other ways.

4. Which medication should the nurse expect to administer to a child diagnosed with Nephrotic Syndrome to decrease proteinuria?

• A. Albumin
• B. Prednisone
• C. Penicillin
• D. Furosemide (Lasix)

Correct answer: B

Rationale: Prednisone, a corticosteroid, is the primary treatment for Nephrotic Syndrome as it helps to reduce inflammation in the kidneys and decrease proteinuria by stabilizing the glomerular filtration barrier. Albumin is a protein replacement therapy and would not directly decrease proteinuria. Penicillin is an antibiotic that treats bacterial infections and is not used to manage Nephrotic Syndrome. Furosemide is a diuretic that helps in managing fluid retention but does not specifically target proteinuria in Nephrotic Syndrome.

5. Which of the following is a hallmark sign of intussusception in children?

• A. Bilious vomiting
• B. "Currant jelly" stools
• C. Abdominal distention
• D. Constipation

Correct answer: B

Rationale: "Currant jelly" stools, consisting of mucus and blood, are characteristic of intussusception in children. It occurs due to the telescoping of a segment of the intestine into an adjacent segment, leading to obstruction and subsequent mucosal ischemia, causing the passage of bloody mucus in the stool. Bilious vomiting can be seen in other conditions like bowel obstruction, abdominal distention can be present but is not as specific, and constipation is less likely in the presentation of intussusception.

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