Nursing Elites

1. A 2-year-old child with a diagnosis of hemophilia is admitted to the hospital. What should the nurse include in the care plan?

• A. Encourage participation in contact sports
• B. Use a soft toothbrush for oral care
• C. Administer nonsteroidal anti-inflammatory drugs
• D. Administer aspirin for pain

Correct answer: B

Rationale: Using a soft toothbrush helps to prevent bleeding in a child with hemophilia.

2. A 4-year-old child is admitted to the hospital with a diagnosis of epiglottitis. What is the priority nursing intervention?

• A. Administer antibiotics
• B. Provide humidified oxygen
• C. Keep the child NPO
• D. Position the child upright

Correct answer: C

Rationale: The priority nursing intervention for a 4-year-old child admitted with epiglottitis is to keep the child NPO (nothing by mouth). This is crucial to prevent further airway compromise due to the inflamed epiglottis. Administering antibiotics may be necessary but is not the priority at this moment. Providing humidified oxygen can support oxygenation but does not address the immediate risk of airway obstruction. Positioning the child upright may help with breathing but does not address the risk of aspiration. Keeping the child NPO is essential to maintain a patent airway and prevent complications associated with epiglottitis.

3. A nurse is teaching a class about immunizations to members of a grammar school’s Parent-Teachers Association. Which childhood disease is the nurse discussing when explaining that it is a viral disease that starts with malaise and a highly pruritic rash that begins on the abdomen, spreads to the face and proximal extremities, and can result in grave complications?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is C, Chickenpox (varicella). Chickenpox is a viral disease characterized by a highly pruritic rash that typically starts on the abdomen and then spreads to other parts of the body, including the face and proximal extremities. It can lead to complications such as pneumonia and encephalitis. Rubella (German measles) presents with a mild rash and swollen lymph nodes; Rubeola (measles) also presents with a rash but starts on the face before spreading downwards; Scarlet fever is caused by Group A Streptococcus bacteria and is characterized by a rash, fever, and sore throat.

4. A child with a diagnosis of congenital heart disease is admitted to the hospital. What should the nurse include in the child’s care plan?

• A. Monitoring fluid status
• B. Encouraging activity
• C. Promoting a high-calorie diet
• D. Maintaining oxygen therapy

Correct answer: A

Rationale: Monitoring fluid status is crucial for a child with congenital heart disease because these children are at risk of fluid overload, which can exacerbate their condition. Monitoring fluid intake and output helps prevent complications such as heart failure. Encouraging activity may be important, but it should be done cautiously and within limits due to the child's cardiac condition. Promoting a high-calorie diet is not typically a priority in congenital heart disease care unless there are specific indications. Maintaining oxygen therapy may be necessary in some cases but is not the primary intervention for managing congenital heart disease.

5. When teaching a class about trisomy 21, the instructor would identify the cause of this disorder as:

• A. nondisjunction.
• B. X-linked recessive inheritance.
• C. genomic imprinting.
• D. autosomal dominant inheritance.

Correct answer: A

Rationale: The correct answer is A: nondisjunction. Trisomy 21, also known as Down syndrome, is caused by nondisjunction, which is an error in cell division leading to an extra copy of chromosome 21. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome. Choices B, C, and D are incorrect. X-linked recessive inheritance refers to genetic disorders carried on the X chromosome, genomic imprinting involves gene expression based on parental origin, and autosomal dominant inheritance relates to disorders caused by a dominant gene on one of the non-sex chromosomes. In the case of trisomy 21, the cause is specifically related to the error in chromosome division, making nondisjunction the most appropriate answer.

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