Nursing Elites

1. A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

• A. The child may not be pain-free.
• B. The parents or nurse may push the button for a bolus if needed.
• C. The pump allows for a continuous basal rate to deliver a constant amount of medication for pain control.
• D. Monitoring is required every 1 to 2 hours to assess patient response.

Correct answer: C

Rationale: The correct answer is C because the PCA pump can be programmed to deliver a continuous basal rate of pain medication to maintain pain control. While the goal of PCA is effective pain relief, it does not guarantee a pain-free state. In the case of a 5-year-old child, the parents or nurse can administer boluses if necessary since the child may not fully comprehend using the PCA button. Monitoring every 1 to 2 hours for patient response is adequate and there is no need for monitoring every 15 minutes, as stated in choice D, unless specific circumstances dictate more frequent monitoring.

2. What diet is most appropriate for the child with chronic renal failure (CRF)?

• A. Low in protein
• B. Low in vitamin D
• C. Low in phosphorus
• D. Supplemented with vitamins A, E, and K

Correct answer: C

Rationale: A low-phosphorus diet is important in managing chronic renal failure to prevent hyperphosphatemia and its associated complications, such as bone disease. Protein intake should be controlled but not necessarily low, and vitamin D supplementation is often required, not reduced.

3. An important role of the nurse in ambulatory settings and schools is the identification of communicable diseases for treatment and the prevention of spread. What is an important component related to the first period of the contagiousness of disease?

• A. Source
• B. Causative agent
• C. Prodromal stage
• D. Constitutional symptoms

Correct answer: C

Rationale: The prodromal period is the interval between the early manifestations of the disease and the time when the overt clinical syndrome is evident. Most communicable diseases are contagious during this time. Identifying the prodromal stage is crucial for early intervention and preventing the spread of the disease. While the source and causative agent are important aspects of disease control, recognizing the early signs in the prodromal stage allows the nurse to take timely actions. Constitutional symptoms occur during the active disease phase, indicating that the child has already been contagious, and early intervention opportunities may have passed.

4. The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?

• A. Lack of congruence among family members
• B. Clear set of family values, rules, and beliefs
• C. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
• D. Sense of commitment toward growth of individual family members as opposed to that of the family unit

Correct answer: B

Rationale: Strong families have a clear set of values, rules, and beliefs that guide their interactions and help them function effectively as a unit.

5. An infant, age 6 months, has six teeth. The nurse should recognize that this is what?

• A. Normal tooth eruption
• B. Delayed tooth eruption
• C. Unusual and dangerous
• D. Earlier than expected tooth eruption

Correct answer: D

Rationale: Having six teeth at 6 months is earlier than the typical tooth eruption schedule, but it is not unusual or dangerous. It is within the range of normal variations in infant development.

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