Nursing Elites

1. A 7-month-old girl is to be catheterized to obtain a sterile urine specimen. One of the infant’s parents expresses fear that this procedure may traumatize the baby psychologically. How should the nurse provide reassurance?

• A. The fear is justified and the nurse should obtain a “clean catch” specimen.
• B. Parents have a right to refuse the catheterization and the concerns are realistic.
• C. Although the concern is appropriate, the need for a sterile specimen is the priority.
• D. The procedure is uncomfortable, but there should not be a damaging long-term effect.

Correct answer: D

Rationale: While catheterization can be uncomfortable, it does not typically result in long-term psychological harm, and obtaining a sterile specimen is important for accurate diagnosis.

2. A healthcare provider is assessing a child with suspected Kawasaki disease. What clinical manifestation is the healthcare provider likely to observe?

• A. Generalized rash
• B. Peeling skin on the hands and feet
• C. High fever
• D. Low-grade fever

Correct answer: B

Rationale: Peeling skin on the hands and feet is a characteristic clinical manifestation of Kawasaki disease, known as desquamation. This occurs during the convalescent phase of the illness. While Kawasaki disease is associated with a high fever, which is a common early sign, and can also present with other symptoms like conjunctivitis, mucous membrane changes, and lymphadenopathy, the peeling skin on the hands and feet is a classic feature that distinguishes Kawasaki disease from other conditions. Generalized rash is not a specific hallmark of Kawasaki disease, and low-grade fever is not typically associated with this condition. Therefore, the correct answer is B, peeling skin on the hands and feet, which is a key feature of Kawasaki disease.

3. What should the nurse advise the parents of a child with asthma on preventing asthma attacks?

• A. Avoid exposure to allergens
• B. Encourage regular exercise
• C. Provide a high-protein diet
• D. Increase fluid intake

Correct answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.

4. A child with a diagnosis of diabetes insipidus is admitted to the hospital. What is the priority nursing intervention?

• A. Administering insulin
• B. Monitoring fluid balance
• C. Administering diuretics
• D. Monitoring vital signs

Correct answer: B

Rationale: The correct priority nursing intervention for a child diagnosed with diabetes insipidus is to monitor fluid balance. Diabetes insipidus is a condition characterized by excessive urination and thirst, which can lead to dehydration. Monitoring fluid balance is essential to prevent dehydration and ensure the child's hydration status remains stable. Administering insulin (Choice A) is not indicated in diabetes insipidus because it is a disorder of the posterior pituitary gland, not the pancreas. Administering diuretics (Choice C) would exacerbate fluid loss in a child already at risk for dehydration. Monitoring vital signs (Choice D) is important but not the priority when compared to maintaining fluid balance in a child with diabetes insipidus.

5. A school nurse is teaching parents of school-age children about the importance of immunizations for childhood communicable diseases. What preventable disease may cause the complication of encephalitis?

• A. Varicella
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is Varicella (chickenpox), choice A. Varicella can lead to the complication of encephalitis, which is the inflammation of the brain. Scarlet fever (choice B) is caused by Group A Streptococcus bacteria and does not typically lead to encephalitis. Poliomyelitis (choice C) is a viral infection that affects the nervous system but does not directly cause encephalitis. Whooping cough (choice D), also known as pertussis, primarily affects the respiratory system and does not commonly result in encephalitis.

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