Nursing Elites

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

• A. Maintain a structured routine
• B. Encourage social interaction
• C. Use positive reinforcement
• D. Use a communication board

Correct answer: A

Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit from a structured routine as it provides them with stability and predictability, which can help reduce anxiety and improve behavior management. Encouraging social interaction (Choice B) may not be suitable for all children with autism, as some may struggle with social skills. While positive reinforcement (Choice C) is a helpful strategy, maintaining a structured routine is more essential for overall management in children with autism spectrum disorder. Using a communication board (Choice D) may be beneficial for communication, but establishing a structured routine is a foundational strategy that should be prioritized in the discharge teaching for a child with autism spectrum disorder.

2. .The parents of a 6-week-old infant who was born without an immune system ask a nurse why their baby is still so healthy. How should the nurse reply?

• A. Exposure to pathogens during this time can be limited.
• B. Some antibodies are produced by the infant’s colonic bacteria.
• C. Antibodies are passively received from the mother through the placenta and breast milk.
• D. Fewer antibodies are produced by the fetal thymus during the eighth and ninth months of gestation.

Correct answer: C

Rationale: Infants receive passive immunity through antibodies from the mother during pregnancy and breastfeeding, which protect them initially.

3. A group of students is reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state:

• A. Endocrine glands begin developing in the first trimester of gestation.
• B. At birth, the endocrine glands are not fully functional.
• C. Infants may have difficulty balancing glucose and electrolytes.
• D. A child’s endocrine system plays a vital role in growth and development.

Correct answer: C

Rationale: The correct statement is that infants may have difficulty balancing glucose and electrolytes because their endocrine systems are immature. Newborns have developing endocrine glands that are not yet fully functional, leading to challenges in maintaining glucose and electrolyte balance. Choice A is incorrect as endocrine glands start developing in the first trimester, not the third trimester. Choice B is incorrect as endocrine glands are not fully functional at birth. Choice D is incorrect because while a child’s endocrine system indeed plays a vital role in growth and development, the specific focus of the question is on the challenges infants face due to immature endocrine glands.

4. What is important to include in discharge instructions for parents of a child who has had a tonsillectomy?

• A. Encourage the child to gargle with salt water
• B. Encourage fluid intake
• C. Provide the child with hard candy
• D. Apply heat to the neck

Correct answer: B

Rationale: Encouraging fluid intake is essential in the discharge instructions for a child who has had a tonsillectomy. It helps keep the throat moist, aids in preventing dehydration, and promotes healing. Gargling with salt water is not typically recommended after a tonsillectomy as it may irritate the surgical site. Providing the child with hard candy is not advisable as it can irritate the throat and potentially cause harm. Applying heat to the neck is also not recommended post-tonsillectomy as it can increase swelling and discomfort in the surgical area.

5. A child with a diagnosis of gastroenteritis is admitted to the hospital. What is the priority nursing intervention?

• A. Monitoring fluid and electrolyte balance
• B. Encouraging regular exercise
• C. Administering antipyretics
• D. Administering antibiotics

Correct answer: A

Rationale: The correct answer is monitoring fluid and electrolyte balance. Gastroenteritis is characterized by inflammation of the gastrointestinal tract, leading to fluid loss. Maintaining fluid and electrolyte balance is essential in managing gastroenteritis to prevent dehydration and electrolyte imbalances. Encouraging regular exercise (Choice B) is not a priority in the acute phase of gastroenteritis when the focus is on rehydration and symptom management. Administering antipyretics (Choice C) may be considered for fever management but is not the priority over monitoring fluid and electrolyte balance. Administering antibiotics (Choice D) is not routinely indicated for viral gastroenteritis, which is a common cause of the condition in children.

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