Nursing Elites

1. A 3-year-old with HIV infection is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first?

• A. Remove the child who has HIV from the foster home.
• B. Report the exposure of the child with HIV to the health department.
• C. Place the child who has HIV in reverse isolation.
• D. Review the immunization documentation of the child who has HIV.

Correct answer: D

Rationale: The priority action for the nurse is to review the immunization documentation of the child with HIV to ensure they have received the necessary vaccines. This step is crucial in protecting the child's health and preventing further complications from vaccine-preventable diseases like pertussis. By reviewing the immunization documentation first, the nurse can determine the child's protection against pertussis and other infectious diseases. Removing the child from the foster home (Choice A) may not be necessary if the child is adequately vaccinated. Reporting the exposure to the health department (Choice B) and placing the child in reverse isolation (Choice C) are important steps but reviewing the immunization status takes precedence to assess the child's protection and guide further actions.

2. A child who weighs 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every 4 hours. How many milligrams should the nurse administer to the child for each dose?

• A. 1875 mg
• B. 625 mg
• C. 2000 mg
• D. 1500 mg

Correct answer: A

Rationale: To calculate the dose for each administration, multiply the child's weight (25 kg) by the dose (300 mg/kg/24 hours) and divide by the number of doses per day (6, as doses are every 4 hours). This gives us (25 kg * 300 mg/kg / 24 hours) / 6 doses = 1875 mg. Therefore, the nurse should administer 1875 mg for each dose. Choice B, 625 mg, is incorrect as it does not consider the correct calculation based on the weight and prescribed dose. Choice C, 2000 mg, is incorrect as it is not derived from the correct dosage calculation. Choice D, 1500 mg, is incorrect as it does not reflect the accurate dosage calculation based on the weight of the child and the prescribed dose.

3. The mother of a 4-month-old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide?

• A. At diaper change generously powder the baby's diaper area with talcum powder to promote dryness.
• B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown.
• C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.
• D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.

Correct answer: C

Rationale: Using a barrier cream like zinc oxide protects the skin and helps prevent diaper rash.

4. A 2-year-old girl is brought to the clinic by her 17-year-old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother?

• A. A 2-year-old should be speaking in 2-word phrases
• B. Dental caries is associated with drinking soda
• C. Drinking soda is related to childhood obesity
• D. Toddlers should be sleeping 10 hours a night

Correct answer: B

Rationale: Dental caries are a common concern when children consume sweetened sodas regularly.

5. A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?

• A. Place the child in a quiet environment
• B. Make a list of foods that the child likes
• C. Encourage the parents to rest when possible
• D. Apply lotion to hands and feet

Correct answer: A

Rationale: The correct intervention for a child with Kawasaki disease, presenting with irritability and skin peeling, is to place the child in a quiet environment. This helps reduce environmental stimuli, calming the child and aiding in managing the symptoms associated with the disease. Choice B is incorrect as addressing food preferences is not the priority in this situation. Choice C is incorrect as the focus should be on the child's immediate needs. Choice D is incorrect as applying lotion is not the first-line intervention for Kawasaki disease symptoms.

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