Nursing Elites

1. Which of the following conditions is characterized by a 'machine-like' murmur in children?

• A. Patent ductus arteriosus
• B. Ventricular septal defect
• C. Atrial septal defect
• D. Coarctation of the aorta

Correct answer: A

Rationale: The correct answer is A, Patent ductus arteriosus. This condition is characterized by a continuous 'machine-like' murmur due to abnormal blood flow between the aorta and pulmonary artery. Ventricular septal defect (choice B) is characterized by a harsh holosystolic murmur, atrial septal defect (choice C) typically presents with a fixed split S2 and a pulmonary flow murmur, and coarctation of the aorta (choice D) is associated with a systolic murmur in the back and bilateral lower extremities.

2. Parents of a preschool child ask the nurse, "Should we set rules for our child as part of a discipline plan?" Which is an accurate response by the nurse?

• A. It is best to delay the punishment if a rule is broken.
• B. The child is too young for rules. At this age, unrestricted freedom is best.
• C. It is best to set the rules and reason with the child when the rules are broken.
• D. Set clear and reasonable rules and expect the same behavior regardless of the circumstances.

Correct answer: D

Rationale: Clear and reasonable rules provide structure and help children understand expectations, promoting consistent behavior and discipline.

3. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

4. The nurse's approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?

• A. The child may think the equipment is alive.
• B. Explaining the equipment will only increase the child’s fear
• C. One brief explanation will be enough to reduce the child’s fear
• D. The child is too young to understand what the equipment does

Correct answer: A

Rationale: Preschoolers may engage in magical thinking and believe inanimate objects are alive, so the nurse should explain the equipment in a way that reduces fear.

5. A mother has just given birth to a newborn with a cleft lip. Sensing that something is wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" What is the most appropriate nursing action?

• A. Encourage the mother to express her feelings
• B. Explain in simple language that the baby has a cleft lip
• C. Provide emotional support until the practitioner can talk to the mother
• D. Tell the mother a pediatrician will talk to her as soon as the baby is examined

Correct answer: A

Rationale: Encouraging the mother to express her feelings allows her to process the situation and prepares her for receiving further information in a supportive environment.

Similar Questions