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. An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?

• A. Renal colic
• B. Strong urinary stream
• C. Urinary tract infections
• D. Post urination dribbling

Correct answer: D

Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.

3. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?

• A. "We should watch for aggressive play."
• B. "Our child may show lasting symptoms of stress."
• C. "We know that our child will show caring behaviors."
• D. "Our child may have difficulty concentrating in school."

Correct answer: C

Rationale: Children exposed to chronic violence may struggle with stress and concentration but are less likely to consistently exhibit caring behaviors without intervention and support.

4. An eleven-year-old boy is admitted with a history of type 1 diabetes. What information about school age should the nurse use to formulate the teaching plan for daily injections?

• A. The parents do not need to learn the procedure.
• B. The child is old enough to give most of his injections.
• C. Self-injections will be possible when he is closer to adolescence.
• D. The child can learn about self-injections when he is able to reach all injection sites.

Correct answer: B

Rationale: By the age of eleven, many children are capable of administering their own insulin injections with supervision, fostering independence and better management of their diabetes. This age is appropriate for the child to take on more responsibility for their care. While parental involvement is still crucial for supervision and guidance, the child can start to learn and perform the injections themselves. Choice A is incorrect because parental involvement is important for safety and proper technique. Choice C is incorrect as waiting until closer to adolescence may delay the child's ability to manage their diabetes effectively. Choice D is incorrect as reaching injection sites is not the sole criteria; proper technique and supervision are essential.

5. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?

• A. Tachycardia
• B. Slow respirations
• C. Warm, flushed skin
• D. Decreased blood pressure

Correct answer: A

Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.

Similar Questions