Nursing Elites

1. A 2-year-old child with a diagnosis of atopic dermatitis is being discharged. What should the nurse include in the discharge teaching?

• A. Avoid triggers that cause flare-ups
• B. Apply topical corticosteroids as prescribed
• C. Use a soft toothbrush for oral care
• D. Avoid contact with sick individuals

Correct answer: B

Rationale: The correct answer is to apply topical corticosteroids as prescribed. Atopic dermatitis is a chronic inflammatory skin condition that can be managed with topical corticosteroids to reduce inflammation and itching. While avoiding triggers that cause flare-ups is important in managing atopic dermatitis, the primary treatment approach involves using prescribed medications like corticosteroids. Using a soft toothbrush for oral care and avoiding contact with sick individuals are not directly related to managing atopic dermatitis and are not the priority discharge teachings in this case.

2. A nurse is reviewing the immunization schedule of an 11-month-old infant. What immunizations does the nurse expect the infant to have previously received?

• A. Pertussis, tetanus, polio, and measles
• B. Diphtheria, pertussis, tetanus, and polio
• C. Rubella, polio, tuberculosis, and pertussis
• D. Measles, mumps, rubella, and tuberculosis

Correct answer: B

Rationale: By 11 months of age, the recommended vaccines for infants include diphtheria, pertussis, tetanus, and polio. These vaccines are part of the routine immunization schedule to protect infants from serious infectious diseases. Choice A is incorrect because measles is not typically administered at this age. Choice C is incorrect because rubella and tuberculosis are not part of routine infant immunizations. Choice D is incorrect because measles, mumps, and rubella are usually given as a combination vaccine later in childhood, not at 11 months of age.

3. A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is essential for managing type 1 diabetes mellitus. Hypoglycemia, which occurs when blood glucose levels drop too low, can be dangerous and requires immediate intervention to prevent severe complications. Monitoring blood glucose levels more frequently than once a day, following a strict meal plan, and administering insulin only when blood glucose is high are important aspects of diabetes management but recognizing signs of hypoglycemia is crucial as it enables prompt action to prevent adverse outcomes.

4. What should be included in the preoperative teaching for a 4-year-old child scheduled for a tonsillectomy?

• A. Explaining the procedure in detail
• B. Encouraging deep breathing exercises
• C. Discussing the importance of hydration
• D. Using play therapy to prepare the child

Correct answer: B

Rationale: Encouraging deep breathing exercises is important preoperative teaching for a child scheduled for a tonsillectomy. Deep breathing exercises can help the child relax and reduce anxiety, which is beneficial before the procedure. Explaining the procedure in detail might be overwhelming for a 4-year-old, whereas encouraging deep breathing exercises can be more beneficial in promoting relaxation and preparing the child. Discussing the importance of hydration is crucial for postoperative care but may not be the priority for preoperative teaching. Using play therapy can help prepare the child, but encouraging deep breathing exercises is more directly related to relaxation and preparation for the procedure.

5. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?

• A. Erythematous papulovesicular rash
• B. Dry, red, scaly rash with lichenification
• C. Pustular vesicles with honey-colored exudates
• D. Hypopigmented oval scaly lesions

Correct answer: B

Rationale: In atopic dermatitis, the nurse would expect to observe a dry, red, scaly rash with lichenification. Lichenification is thickened skin due to chronic scratching. Choices A, C, and D are incorrect. Erythematous papulovesicular rash is more characteristic of contact dermatitis, pustular vesicles with honey-colored exudates are seen in impetigo, and hypopigmented oval scaly lesions are typical of pityriasis alba.

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