Nursing Elites

1. A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?

• A. Refer him for immediate medical evaluation
• B. Administer analgesics and recommend scrotal support.
• C. Apply an ice bag and observe for increasing pain.
• D. Reassure the adolescent that occasional pain is common with the changes of puberty.

Correct answer: A

Rationale: Sudden and severe scrotal pain in an adolescent male is a medical emergency and may indicate testicular torsion, which requires immediate evaluation and intervention to prevent testicular loss.

2. What does the Hib conjugate vaccine protect against?

• A. Bacterial meningitis
• B. Epiglottitis
• C. Bacterial pneumonia
• D. All Correct

Correct answer: D

Rationale: The Hib conjugate vaccine is crucial for protecting children from several severe infections caused by Haemophilus influenzae type b, including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. Therefore, all the provided options are correct. Bacterial meningitis, epiglottitis, and bacterial pneumonia are serious conditions that the Hib vaccine effectively prevents, making choice D the correct answer. Choices A, B, and C are incorrect when considered individually as the Hib vaccine does not protect against only one specific infection; rather, it provides immunity against multiple diseases caused by Haemophilus influenzae type b.

3. A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response?

• A. It is best to wait until the child asks about it.
• B. The best time to tell the child is between the ages of 7 and 10 years.
• C. It is not necessary to tell a child who was adopted so young.
• D. Telling the child is an important aspect of their parental responsibilities.

Correct answer: D

Rationale: It is important to tell children about their adoption early, in an age-appropriate manner, as part of building trust and openness in the family relationship.

4. The nurse suspects fluid overload in an infant receiving intravenous fluids. What clinical manifestation is suggestive of water intoxication?

• A. Oliguria
• B. Weight loss
• C. Irritability and seizures
• D. Muscle weakness and cardiac dysrhythmias

Correct answer: C

Rationale: Water intoxication can lead to cerebral edema, causing neurological symptoms such as irritability and seizures. Oliguria, weight loss, and muscle weakness are not typical signs of water intoxication.

5. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

• A. Safe administration of daily enemas
• B. Necessity of firm stools to keep suture line clean
• C. Bowel training beginning as soon as the child returns home
• D. Changes in stooling patterns to report to the practitioner

Correct answer: D

Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.

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