Nursing Elites

1. Which nursing intervention provides the most support to the parents of an infant with an obvious physical anomaly?

• A. Encourage them to express their concerns.
• B. Discourage them from talking about their baby.
• C. Assure them not to worry because the anomaly can be repaired.
• D. Show them postoperative photographs of infants who had a similar anomaly.

Correct answer: A

Rationale: Encouraging parents to express their concerns is the most supportive intervention because it allows them to process their emotions and provides them with an opportunity to share their fears, anxieties, and questions. This open communication helps the nurse to offer appropriate support, education, and reassurance. Discouraging parents from talking about their baby (Choice B) can hinder their emotional expression and prevent them from seeking necessary information and support. Assuring parents not to worry (Choice C) may invalidate their feelings and minimize the significance of their concerns. Showing postoperative photographs (Choice D) may not be appropriate at this stage as parents need emotional support and education about the current situation before focusing on postoperative outcomes.

2. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection?

• A. Burn wound cellulitis.
• B. Invasive burn cellulitis.
• C. Burn impetigo.
• D. Staphylococcal scalded skin syndrome.

Correct answer: B

Rationale: Invasive burn cellulitis is characterized by the burn developing a dark brown, black, or purplish color with discharge and a foul odor. This description aligns with the symptoms observed in the 15-year-old boy. Burn wound cellulitis (Choice A) typically presents with erythema, edema, warmth, and tenderness at the burn site, without the characteristic changes seen in this case. Burn impetigo (Choice C) is a superficial infection characterized by honey-colored crusts, not consistent with the purplish color and foul odor described. Staphylococcal scalded skin syndrome (Choice D) is a condition caused by exotoxins produced by Staphylococcus aureus, leading to widespread desquamation of the skin, but it does not typically present with the specific findings mentioned in the scenario.

3. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

• A. They will increase tidal volumes.
• B. Drainage of air and fluid will be facilitated.
• C. They will maintain positive intrapleural pressure.
• D. Pressure on the pericardium and chest wall will be regulated.

Correct answer: B

Rationale: Chest tubes are used to drain air and fluid from the chest cavity to prevent complications such as pneumothorax or cardiac tamponade after surgery. Choice A is incorrect as chest tubes are not used to increase tidal volumes. Choice C is incorrect as chest tubes do not maintain positive intrapleural pressure; instead, they assist in removing excess air or fluid. Choice D is incorrect as chest tubes do not regulate pressure on the pericardium and chest wall; they primarily aid in drainage.

4. A school nurse is teaching parents of school-age children about the importance of immunizations for childhood communicable diseases. What preventable disease may cause the complication of encephalitis?

• A. Varicella
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is Varicella (chickenpox), choice A. Varicella can lead to the complication of encephalitis, which is the inflammation of the brain. Scarlet fever (choice B) is caused by Group A Streptococcus bacteria and does not typically lead to encephalitis. Poliomyelitis (choice C) is a viral infection that affects the nervous system but does not directly cause encephalitis. Whooping cough (choice D), also known as pertussis, primarily affects the respiratory system and does not commonly result in encephalitis.

5. What finding would the nurse expect to assess in a child with hypothyroidism?

• A. Nervousness
• B. Heat intolerance
• C. Smooth velvety skin
• D. Weight gain

Correct answer: D

Rationale: Weight gain is the expected finding in a child with hypothyroidism. Hypothyroidism leads to a slowed metabolism, which can result in weight gain. Choices A, B, and C are not typical findings in hypothyroidism. Nervousness and heat intolerance are more commonly associated with hyperthyroidism, where the body is in a state of overactivity. Smooth velvety skin is not a characteristic sign of hypothyroidism.

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