Nursing Elites

1. Which statement best describes colic?

• A. Periods of abdominal pain resulting in weight loss
• B. Usually the result of poor or inadequate mothering
• C. Periods of abdominal pain and crying occurring in infants older than age 6 months
• D. A paroxysmal abdominal pain or cramping manifested by episodes of loud crying

Correct answer: D

Rationale: Colic is characterized by episodes of loud, inconsolable crying, often due to abdominal discomfort, and typically occurs in infants younger than 6 months. It is not related to poor mothering, nor does it necessarily result in weight loss.

2. The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those ‘shots’ and take pills like an uncle does. How should the nurse respond?

• A. The pills work with adult pancreases only.
• B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
• C. The drugs affect fat and protein metabolism, not sugar.
• D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.

Correct answer: B

Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.

3. The nurse is caring for a 2-year-old child in the postoperative period. Which pain assessment tool is most appropriate for assessing pain intensity in a 2-year-old?

• A. Poker chip tool
• B. Oucher Scale
• C. Faces Pain Rating Scale
• D. FLACC Behavioral Pain Assessment Scale

Correct answer: D

Rationale: The FLACC Behavioral Pain Assessment Scale is the most suitable tool for assessing pain in 2-year-old children postoperatively. It assesses pain by evaluating facial expression, leg movement, activity, cry, and consolability, making it effective for non-verbal children. The Poker chip tool is not appropriate for this age group. The Oucher Scale and Faces Pain Rating Scale are more suitable for older children who can self-report pain levels.

4. What approach is the most appropriate when performing a physical assessment on a toddler?

• A. Demonstrate the use of equipment
• B. Perform traumatic procedures last
• C. Use minimum physical contact initially
• D. Always proceed systematically in a head-to-toe direction

Correct answer: C

Rationale: The most appropriate approach when performing a physical assessment on a toddler is to use minimum physical contact initially. This helps gain the toddler's cooperation and reduces their distress. Performing traumatic procedures last is crucial as they are likely to upset the child and should be handled with care. Demonstrating the use of equipment may be complex for toddlers to understand, so it is not the most appropriate initial approach. Proceeding systematically in a head-to-toe direction is a good practice but using minimum physical contact initially is more important to establish trust and cooperation with the toddler.

5. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.)

• A. Rash
• B. Urticaria
• C. All are applicable
• D. Photosensitivity

Correct answer: C

Rationale: Trimethoprim-sulfamethoxazole (Bactrim) can cause side effects like rash, urticaria, and photosensitivity. Parents and the child should be educated on these potential side effects to ensure prompt recognition and management.

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