Nursing Elites

1. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?

• A. Safe administration of daily enemas
• B. Necessity of firm stools to keep suture line clean
• C. Bowel training beginning as soon as the child returns home
• D. Changes in stooling patterns to report to the practitioner

Correct answer: D

Rationale: Postoperative care should focus on monitoring changes in stooling patterns, which could indicate complications such as stenosis or obstruction. It is crucial to educate the family on the importance of promptly reporting any changes in stooling patterns to the healthcare provider. Options A and B are not recommended unless specifically ordered by the physician as they can potentially cause harm or discomfort postoperatively. Option C may not be appropriate immediately after surgery and should be guided by the healthcare provider's recommendations.

2. Which clinical manifestations should the nurse expect in a child diagnosed with nephroblastoma?

• A. Atrial fibrillation
• B. Endocarditis
• C. Hyperlipidemia
• D. Hypertension

Correct answer: D

Rationale: The correct answer is D: Hypertension. Nephroblastoma, also known as Wilms' tumor, often causes hypertension due to its impact on the kidney, which plays a role in regulating blood pressure. Atrial fibrillation (choice A) and endocarditis (choice B) are not typically associated with nephroblastoma. Hyperlipidemia (choice C) is also not a common clinical manifestation of nephroblastoma.

3. While making rounds, the nurse observes the following client behaviors. Which child should the nurse further evaluate for postoperative pain?

• A. The 6-month-old in deep sleep
• B. The 2-year-old who is cooperative when the nurse takes vital signs
• C. The 4-year-old who is actively watching cartoons
• D. The 14-month-old who is screaming and thrashing his arms and legs

Correct answer: D

Rationale: The correct answer is D because screaming and thrashing his arms and legs are indicative behaviors of discomfort or pain in young children. The child's actions suggest a higher likelihood of experiencing postoperative pain and necessitate further evaluation. Choices A, B, and C do not exhibit overt signs of distress or discomfort associated with pain, making them less likely candidates for postoperative pain assessment.

4. Which distraction technique should be used for an adolescent child during a painful procedure?

• A. Blowing bubbles
• B. Guided imagery
• C. EMLA cream
• D. Sucrose solution

Correct answer: B

Rationale: The correct answer is B: Guided imagery. Guided imagery is an effective distraction technique for adolescents as it helps them focus on positive mental images instead of the pain. This technique can be a powerful tool in managing pain and anxiety during procedures. Blowing bubbles (choice A) may be more suitable for younger children as it can engage them visually and help distract them. EMLA cream (choice C) is a topical anesthetic and not a distraction technique. Sucrose solution (choice D) is used for pain relief in infants, not typically for adolescents undergoing painful procedures.

5. Play activities of the preschool-age child include:

• A. Having imaginary playmates
• B. Selective collection of objects
• C. Complex board games
• D. Associative play

Correct answer: A

Rationale: The correct answer is A, 'Having imaginary playmates.' Preschool-age children often engage in imaginative play, which includes creating imaginary friends or playmates. This type of play helps them develop creativity, social skills, and emotional expression. Choice B, 'Selective collection of objects,' may be more common in older children and is not a typical play activity for preschoolers. Choice C, 'Complex board games,' are usually beyond the developmental level of preschoolers as they require more advanced cognitive skills. Choice D, 'Associative play,' is a term used to describe a type of play where children play alongside each other but not necessarily together, which is different from the imaginative play involving imaginary playmates that preschoolers often engage in.

Similar Questions