Nursing Elites

1. A child is brought to the clinic after tripping over a rock. The child states, 'I twisted my ankle,' and is given a diagnosis of a sprain. What intervention is most important for the nurse to include in the discharge instructions for this child?

• A. For the first 24 hours, apply ice for 20 minutes and then remove for 60 minutes.
• B. Bed rest with the leg elevated for 36 hours.
• C. May take an NSAID for pain as needed.
• D. Use a compression dressing for 72 hours.

Correct answer: A

Rationale: The correct intervention for a sprained ankle is to apply ice for 20 minutes every hour for the first 24 hours, then remove for 60 minutes to prevent tissue damage. This regimen helps reduce swelling and pain. Bed rest with the leg elevated for an extended period (36 hours) may lead to stiffness and decreased range of motion. While NSAIDs can be used for pain, they may not be necessary if pain is manageable with ice and rest. Using a compression dressing for 72 hours continuously may impede proper circulation and delay healing by restricting blood flow.

2. A child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger or worsen symptoms. Monitoring dietary habits helps identify any potential triggers and ensures proper nutrition, which can impact asthma control. Assessing sleep patterns, academic performance, or behavior at home may provide valuable information in a general health assessment, but when specifically managing asthma, dietary intake assessment is the most relevant.

3. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order?

• A. Corticosteroids.
• B. Antifungals.
• C. Antibiotics.
• D. Retinoids.

Correct answer: B

Rationale: The correct answer is B: Antifungals. Candidal diaper rash is caused by a yeast infection and is best treated with antifungal agents. Corticosteroids (choice A) may worsen fungal infections by suppressing the immune response. Antibiotics (choice C) are used to treat bacterial infections, not fungal infections like candidal diaper rash. Retinoids (choice D) are not typically used to treat candidal diaper rash in infants; they are more commonly used for dermatological conditions like acne.

4. Which cardiac defects are associated with tetralogy of Fallot?

• A. Right ventricular hypertrophy, atrial and ventricular defects, and mitral valve stenosis
• B. Origin of the aorta from the right ventricle and of the pulmonary artery from the left ventricle
• C. Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta
• D. Altered connection between the pulmonary artery and the aorta, right ventricular hypertrophy, and an atrial septal defect

Correct answer: C

Rationale: The correct answer is C: Right ventricular hypertrophy, ventricular septal defect, pulmonic stenosis, and overriding aorta are the cardiac defects associated with Tetralogy of Fallot. In Tetralogy of Fallot, these specific abnormalities contribute to the classic features of the condition. Choice A is incorrect as it includes mitral valve stenosis, which is not typically part of Tetralogy of Fallot. Choice B describes transposition of the great arteries, not Tetralogy of Fallot. Choice D mentions an altered connection between the pulmonary artery and the aorta, which is not a defining characteristic of Tetralogy of Fallot.

5. A healthcare professional is educating a group of parents on preventing childhood obesity. What should the professional recommend?

• A. Encourage high-calorie snacks
• B. Limit screen time
• C. Encourage fast food as a treat
• D. Allow the child to eat freely

Correct answer: B

Rationale: The correct answer is to limit screen time when preventing childhood obesity. Excessive screen time is associated with a sedentary lifestyle and can lead to increased consumption of unhealthy foods. Encouraging high-calorie snacks (choice A) contradicts the goal of preventing obesity. While fast food as an occasional treat (choice C) can be acceptable in moderation, it should not be encouraged as a preventive measure against obesity. Allowing the child to eat freely (choice D) without guidance can lead to overconsumption of unhealthy foods and contribute to obesity risk.

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