Nursing Elites

1. A 4-year-old child is brought to the clinic with complaints of ear pain and fever. The practical nurse suspects otitis media. Which symptom supports this suspicion?

• A. Clear nasal discharge.
• B. Dry, hacking cough.
• C. Tugging at the ear.
• D. Sore throat.

Correct answer: C

Rationale: Tugging at the ear is a common symptom in children with otitis media. It often indicates discomfort or pain in the ear, suggesting inflammation or infection in the middle ear. This behavior is frequently observed in young children who are unable to express their discomfort verbally, making it a significant clinical indicator for otitis media in this age group. Clear nasal discharge (Choice A) is more indicative of a cold or allergies, while a dry, hacking cough (Choice B) is not typically associated with otitis media. Although a sore throat (Choice D) can sometimes accompany ear infections, tugging at the ear is a more specific and reliable symptom in this case.

2. What is the priority action for a 2-year-old child with croup presenting with a barking cough and stridor?

• A. Administer a corticosteroid
• B. Obtain a throat culture
• C. Administer nebulized epinephrine
• D. Place the child in an upright position

Correct answer: C

Rationale: The priority action for a 2-year-old child with croup and stridor is to administer nebulized epinephrine. Nebulized epinephrine helps reduce airway swelling, alleviate symptoms, and improve breathing by causing vasoconstriction and reducing upper airway edema. Administering a corticosteroid may be done but is not the priority in this scenario. Obtaining a throat culture is not necessary for the immediate management of croup. Placing the child in an upright position can aid in breathing but is not the priority action when the child is presenting with stridor.

3. A child with cystic fibrosis is admitted to the hospital with respiratory distress. Which intervention should the practical nurse (PN) implement?

• A. Administer bronchodilators as prescribed.
• B. Limit fluid intake.
• C. Provide a high-fat diet.
• D. Encourage bed rest only.

Correct answer: A

Rationale: Administering bronchodilators as prescribed is crucial for managing respiratory distress in children with cystic fibrosis. Bronchodilators help to open the airways, facilitating easier breathing for the child. Limiting fluid intake, providing a high-fat diet, or encouraging bed rest only are not appropriate interventions for respiratory distress associated with cystic fibrosis. Limiting fluid intake could worsen dehydration, a high-fat diet is not recommended due to pancreatic insufficiency in cystic fibrosis, and bed rest alone does not address the respiratory distress.

4. What intervention should the nurse implement first for a male toddler brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin)?

• A. Administer activated charcoal
• B. Prepare gastric lavage
• C. Obtain a 12-lead electrocardiogram
• D. Give IV digoxin immune fab (Digibind)

Correct answer: A

Rationale: Administering activated charcoal is the priority intervention as it binds with digoxin, preventing further absorption in the gastrointestinal tract. This helps reduce the amount of digoxin available for systemic circulation and minimizes its toxic effects. Gastric lavage is no longer recommended due to potential complications and lack of evidence of efficacy. Obtaining an electrocardiogram may help assess the effects of digoxin toxicity, but it is not the initial priority. IV digoxin immune fab (Digibind) is used in severe cases of digoxin toxicity but is not the first-line intervention.

5. A 2-year-old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure?

• A. Describe the side-lying, knees to chest position that must be assumed during the procedure.
• B. Tell the child to expect loud clicking noises during the procedure that may be slightly annoying.
• C. Reassure the child that there will be no restrictions on activity after the procedure is completed.
• D. Explain that fluids cannot be taken for 8 hours before the procedure and for 4 hours after the procedure.

Correct answer: A

Rationale: The correct answer is A. Describing the side-lying, knees to chest position that must be assumed during the lumbar puncture procedure is essential as it helps the child understand what to expect, promotes cooperation, and reduces anxiety. This position is necessary for the procedure to be performed safely and effectively. Choice B is incorrect because mentioning loud clicking noises may increase the child's anxiety. Choice C is incorrect because there may be restrictions on activity after the procedure, depending on individual cases. Choice D is also incorrect as it provides information about fluid intake restrictions that are not directly related to the procedure itself.

Similar Questions