Nursing Elites

1. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?

• A. The child will continue to sleep and be pain-free
• B. Parents cannot administer additional medication with the button
• C. The pump can deliver baseline and bolus dosages
• D. There is a high risk of overdose, so monitoring is done every 15 minutes

Correct answer: C

Rationale: PCA pumps are designed to deliver both a continuous baseline dose and patient-activated bolus doses, which can help manage pain effectively while minimizing the risk of overdose.

2. When assessing a preschooler's chest, what should the nurse expect?

• A. Respiratory movements to be chiefly thoracic
• B. Anteroposterior diameter to be equal to the transverse diameter
• C. Retraction of the muscles between the ribs on respiratory movement
• D. Movement of the chest wall to be symmetric bilaterally and coordinated with breathing

Correct answer: D

Rationale: In a preschooler, chest movement should be symmetric and coordinated with breathing, indicating healthy respiratory function.

3. The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?

• A. Straw
• B. Spoon
• C. Sippy cup
• D. Open cup

Correct answer: D

Rationale: An open cup is recommended for feeding after cleft palate repair to prevent injury to the surgical site and avoid creating negative pressure, which could disrupt the repair.

4. The nurse is providing anticipatory guidance to the parent of a 9-month-old infant during a well-baby visit. Which topic would be most appropriate?

• A. Cautioning about putting the infant in a walker
• B. Advising how to create a toddler-safe home
• C. Instructing on safety procedures during baths
• D. Warning about leaving small objects on the floor

Correct answer: D

Rationale: The correct answer is D because at 9 months, infants become more mobile, increasing the risk of choking hazards from small objects left on the floor. Cautioning about putting the infant in a walker (Choice A) is not as crucial at this age as warning about choking hazards. While advising how to create a toddler-safe home (Choice B) is essential, the most critical concern at 9 months is small objects. Instructing on safety procedures during baths (Choice C) is important but does not address the immediate risk of choking hazards associated with small objects.

5. A school-age client is in the playroom when the respiratory therapist arrives to give a scheduled breathing treatment. What is the most appropriate nursing action?

• A. Escort the child to their room and ask the child-life specialist to bring toys to the bedside
• B. Reschedule the treatment for a later time
• C. Assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed
• D. Show the respiratory therapist to the playroom

Correct answer: C

Rationale: The most appropriate action is to assist the child back to their room for the treatment but reassure them that they may return when the procedure is completed. This approach ensures that the child receives the necessary treatment while also acknowledging their desire to continue playing in the playroom. Choice A is incorrect because it suggests moving the child to the room and asking the child-life specialist to bring toys, which may not be necessary. Choice B is incorrect as rescheduling the treatment may not be in the best interest of the child's health. Choice D is incorrect as the nurse should guide the child back to their room for the treatment.

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