Nursing Elites

1. Which of the following signs or symptoms is more common in children than adults following head trauma?

• A. nausea and vomiting
• B. altered mental status
• C. tachycardia and diaphoresis
• D. changes in pupillary reaction

Correct answer: A

Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.

2. 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.

3. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?

• A. Insulin
• B. Steroids
• C. Antibiotics
• D. Anticonvulsants

Correct answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.

4. When a child with a diagnosis of asthma is prescribed a peak flow meter, what should the nurse teach the child and parents about using this device?

• A. Use the device before taking medication
• B. Use the device during asthma attacks
• C. Record the best of three attempts
• D. Use the device after eating

Correct answer: C

Rationale: The correct answer is to record the best of three attempts when using a peak flow meter. This method provides a more accurate measure of peak expiratory flow. Choice A is incorrect because using the device before taking medication may not reflect the actual peak flow, as medication can affect lung function. Choice B is incorrect as using the device during asthma attacks may not be feasible or safe, as the focus during an attack should be on managing symptoms rather than measuring peak flow. Choice D is incorrect because using the device after eating may not provide an accurate measurement of peak flow, as digestion can affect lung function temporarily.

5. During a physical examination of a 9-month-old baby, the nurse observes a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule.
• B. Macule.
• C. Vesicle.
• D. Scale.

Correct answer: B

Rationale: The correct answer is B: Macule. A macule is a flat, discolored area on the skin that is smaller than 1 cm in diameter. This term is used to describe conditions like freckles or petechiae. Choice A, Papule, refers to a small, solid, raised skin lesion (<0.5 cm) like a pimple. Choice C, Vesicle, describes a small blister filled with clear fluid. Choice D, Scale, refers to flakes or plates of dead skin that may be dry or greasy.

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