Nursing Elites

1. A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition?

• A. Erythrocyte sedimentation rate
• B. Potassium hydroxide prep
• C. Wound culture
• D. Serum immunoglobulin E (IgE) level

Correct answer: D

Rationale: The correct answer is D: Serum immunoglobulin E (IgE) level. An elevated serum IgE level is commonly associated with atopic dermatitis, reflecting an allergic response. Choice A, erythrocyte sedimentation rate, is a nonspecific test for inflammation and not specific to atopic dermatitis. Choice B, potassium hydroxide prep, is used to diagnose fungal infections like tinea versicolor, not atopic dermatitis. Choice C, wound culture, is not typically indicated for the diagnosis of atopic dermatitis as it is a chronic inflammatory skin condition rather than an infectious process.

2. A child with a diagnosis of appendicitis is scheduled for surgery. What preoperative intervention is important for the nurse to perform?

• A. Administering antibiotics
• B. Maintaining strict NPO status
• C. Encouraging fluid intake
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The correct preoperative intervention for a child with appendicitis scheduled for surgery is maintaining strict NPO (nothing by mouth) status. This is crucial to reduce the risk of aspiration during anesthesia induction and prevent potential complications during surgery. Administering antibiotics may be a part of the treatment plan but is not a preoperative intervention. Encouraging fluid intake is contraindicated preoperatively to avoid delays in surgery and complications related to anesthesia. Monitoring for signs of infection is important postoperatively to assess for any complications that may arise due to the surgical procedure.

3. A child with juvenile idiopathic arthritis (JIA) is under the care of a nurse. What is the priority nursing intervention?

• A. Encouraging a diet high in protein
• B. Administering nonsteroidal anti-inflammatory drugs (NSAIDs)
• C. Applying heat to affected joints
• D. Providing range-of-motion exercises

Correct answer: B

Rationale: The priority nursing intervention for a child with juvenile idiopathic arthritis (JIA) is administering nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation. NSAIDs are commonly used in the treatment of JIA to help alleviate symptoms. While encouraging a diet high in protein, applying heat to affected joints, and providing range-of-motion exercises are essential components of care, addressing pain and inflammation with NSAIDs is the priority intervention. This is because controlling pain and inflammation is crucial in improving the child's comfort and quality of life, which takes precedence over other supportive measures.

4. A 4-year-old child is admitted with a diagnosis of bacterial pneumonia. What is the priority nursing intervention?

• A. Administering antipyretics
• B. Administering antibiotics
• C. Monitoring fluid intake
• D. Providing nutritional support

Correct answer: B

Rationale: The priority nursing intervention for a 4-year-old child admitted with bacterial pneumonia is administering antibiotics. Antibiotics are essential to treat the infection, prevent its spread, and avoid potential complications. Administering antipyretics (Choice A) may help reduce fever but does not address the underlying cause of pneumonia, which is bacterial in this case. Monitoring fluid intake (Choice C) is important to maintain hydration but does not directly treat the infection. Providing nutritional support (Choice D) is crucial for overall health, but the immediate priority is to address the bacterial infection with antibiotics to prevent further complications and promote recovery.

5. When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'

• A. keep medications in a medicine cabinet.
• B. have secured gates at entrances to staircases.
• C. move our child to a regular bed by the age of three.
• D. buy shoes that fasten with Velcro rather than laces.

Correct answer: C

Rationale: The correct answer is C. Moving a child to a regular bed by the age of three can increase the risk of falls as young toddlers may not have the motor skills to safely navigate a larger bed. This indicates a need for more teaching on safety measures. Choices A, B, and D are all appropriate safety measures that can help prevent accidents and injuries in young children. Keeping medications in a medicine cabinet, having secured gates at entrances to staircases, and choosing shoes that fasten with Velcro instead of laces are all good practices to ensure a safe environment for toddlers.

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