Nursing Elites

1. An 18-month-old was brought to the emergency department by her mother, who states, 'I think she broke her arm.' The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

• A. Plastic deformity.
• B. Buckle fracture.
• C. Spiral fracture.
• D. Greenstick fracture.

Correct answer: C

Rationale: A spiral fracture is characterized by a twisting injury, often indicating child abuse due to the mechanism involved. This type of fracture is commonly seen in non-accidental trauma cases. Plastic deformity is not typically seen on radiographs but refers to a change in the shape of a bone without breaking. Buckle fractures are incomplete fractures commonly seen in children due to their softer bones. Greenstick fractures are also incomplete fractures, but they do not typically raise suspicion of child abuse as spiral fractures do.

2. When planning the discharge of a child who had surgery for a congenital heart defect, what is an important aspect of the discharge teaching?

• A. Teaching the parents about signs of infection
• B. Providing instructions on wound care
• C. Scheduling follow-up appointments
• D. Explaining the use of prescribed medications

Correct answer: D

Rationale: Explaining the use of prescribed medications is crucial because it helps ensure proper management of the child’s condition after discharge. While teaching the parents about signs of infection and providing instructions on wound care are important aspects of postoperative care, they are not as critical as ensuring the correct understanding and administration of prescribed medications. Scheduling follow-up appointments is also important but does not directly impact the immediate post-discharge care and medication adherence.

3. What should be used to feed an infant born with a unilateral cleft lip and palate?

• A. Plastic spoon
• B. Cross-cut nipple
• C. Parenteral infusion
• D. Rubber-tipped syringe

Correct answer: B

Rationale: A cross-cut nipple is the most appropriate choice for feeding an infant with a unilateral cleft lip and palate. Using a cross-cut nipple helps regulate the flow of milk, making feeding easier for the infant and reducing the risk of aspiration. Plastic spoons, parenteral infusion, and rubber-tipped syringes are not recommended for feeding infants with cleft lip and palate as they can pose risks such as choking, aspiration, or inadequate milk intake. It is essential to choose a feeding method that minimizes these risks and ensures proper nutrition for the infant.

4. 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.

5. A 5-year-old child is admitted to the hospital with a diagnosis of bacterial meningitis. What is the priority nursing intervention?

• A. Administering antibiotics
• B. Isolating the child
• C. Monitoring vital signs
• D. Administering fluids

Correct answer: B

Rationale: The priority nursing intervention for a child admitted with bacterial meningitis is isolating the child. Isolation is crucial to prevent the spread of the highly contagious infection to other patients and healthcare workers. Administering antibiotics (Choice A) is important but isolating the child takes precedence to contain the spread of the infection. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care but do not address the immediate need to prevent transmission of the infection.

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