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. What is the priority nursing responsibility when a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure?

• A. Apply restraints.
• B. Administer oxygen.
• C. Protect the child from self-injury.
• D. Insert a plastic airway in the child’s mouth.

Correct answer: C

Rationale: During a tonic-clonic seizure, the priority nursing responsibility is to protect the child from self-injury. Applying restraints is not recommended during a seizure as it can lead to further harm. Administering oxygen may be necessary after the seizure to support oxygenation, but it is not the priority during the seizure itself. Inserting a plastic airway is also not indicated as the jaw is clamped, and the child should not have anything placed in the mouth during a seizure. Therefore, the correct action is to ensure the child's safety by protecting them from self-injury, preventing harm from uncontrolled movements and potential falls.

3. After clearing the airway of a newborn who is not in distress, what is the most important action for you to take?

• A. Apply free-flow oxygen
• B. Clamp and cut the cord
• C. Keep the newborn warm
• D. Obtain an APGAR score

Correct answer: C

Rationale: Keeping the newborn warm is crucial as newborns are at high risk of hypothermia due to their large body surface area and limited subcutaneous fat. Hypothermia can lead to complications such as respiratory distress, hypoglycemia, and metabolic acidosis. Providing warmth helps maintain the newborn's body temperature and supports physiological processes, promoting overall well-being. Applying free-flow oxygen is not necessary if the newborn is not in distress. Clamping and cutting the cord can be done after addressing the immediate need for warmth. Obtaining an APGAR score is important for assessing the newborn's overall condition but ensuring warmth takes precedence to prevent complications related to hypothermia.

4. A parent receives a note from the school that a student in class has head lice. The parent calls the school nurse to ask how to check for head lice. What instructions should the nurse provide?

• A. Ask the child where it itches.
• B. Check to see if your dog has ear mites.
• C. Look along the scalp line for white dots.
• D. Observe between the fingers for red lines.

Correct answer: C

Rationale: The correct answer is to look along the scalp line for white dots (nits) when checking for head lice. White dots/nits are the eggs of head lice and are commonly found attached to the hair shaft near the scalp. This method helps identify if head lice are present. Choice A is incorrect as itching alone may not be a definitive sign of head lice; it could be due to other reasons. Choice B is irrelevant as ear mites in dogs are not related to head lice infestation in humans. Choice D is also incorrect as observing between the fingers for red lines is not a method for checking head lice.

5. A healthcare professional plans to discuss childhood nutrition with a group of parents whose children have Down syndrome in an attempt to minimize a common nutritional problem. What problem should be addressed?

• A. Rickets
• B. Obesity
• C. Anemia
• D. Rumination

Correct answer: B

Rationale: The correct answer is B: Obesity. Children with Down syndrome are at a higher risk of obesity due to various factors such as lower metabolic rate, hormonal imbalances, and reduced physical activity levels. Addressing healthy eating habits early can help prevent obesity in these children. Choice A (Rickets) is incorrect because rickets is primarily associated with vitamin D deficiency and is not a common nutritional problem in children with Down syndrome. Choice C (Anemia) is incorrect as anemia may not be a common nutritional problem specific to children with Down syndrome. Choice D (Rumination) is incorrect as rumination is a behavioral disorder characterized by repeated regurgitation of food and is not a common nutritional problem associated with Down syndrome.

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