Nursing Elites

1. 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 symptoms or exacerbate the condition. By evaluating the child's diet, the nurse can identify potential triggers, ensure the child receives proper nutrition, and help manage symptoms effectively. Assessing sleep patterns, academic performance, or behavior at home, while important in a holistic assessment, are not as directly related to managing asthma symptoms as dietary intake.

2. The nurse is teaching a group of parents about the side effects of immunization vaccines. Which sign should the nurse include when discussing an infant receiving the Haemophilus influenzae (Hib) vaccine?

• A. Lethargy
• B. Urticaria
• C. Generalized rash
• D. Low-grade fever

Correct answer: D

Rationale: The correct answer is 'D. Low-grade fever.' A low-grade fever is a common and mild side effect of the Hib vaccine, indicating that the immune system is responding to the immunization. Lethargy (choice A) can be a sign of more serious adverse effects and should be monitored closely but is not typically associated with the Hib vaccine. Urticaria (choice B) and generalized rash (choice C) are less common side effects of the Hib vaccine compared to low-grade fever.

3. A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse’s most appropriate response?

• A. Praise the parent for the decision and encourage the plan.
• B. Ask for more specific information related to the developmental delays.
• C. Advise the parent to have the healthcare provider help choose an appropriate program.
• D. Explain that this may be a premature action and the developmental delays could disappear.

Correct answer: B

Rationale: The most appropriate response for the nurse in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the situation, offer appropriate support, and provide guidance tailored to the child's specific needs. Praising the parent or encouraging the plan without understanding the full context may not be beneficial. Advising the parent to have the healthcare provider help choose a program assumes the parent has not already involved the healthcare provider, which may not be the case. Explaining that the developmental delays could disappear is not appropriate as it may give false hope or minimize the parent's concerns.

4. When evaluating the laboratory report of a 1-year-old infant’s hematocrit, a healthcare professional compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?

• A. 19% to 32%
• B. 29% to 41%
• C. 37% to 47%
• D. 42% to 69%

Correct answer: C

Rationale: The correct answer is C: 37% to 47%. The normal hematocrit range for a 12-month-old infant is between 37% to 47%, which reflects the expected blood volume and red blood cell levels for this age. Choice A (19% to 32%) and Choice B (29% to 41%) are too low and do not encompass the typical hematocrit range for a healthy 1-year-old. Choice D (42% to 69%) is too high and falls outside the usual hematocrit values for this age group.

5. A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the professional determine is the last sign of heart failure?

• A. Tachypnea
• B. Tachycardia
• C. Peripheral edema
• D. Periorbital edema

Correct answer: C

Rationale: Peripheral edema is often considered the last sign of heart failure in infants and children. It indicates significant fluid retention and circulatory compromise. Tachypnea (increased respiratory rate) and tachycardia (increased heart rate) are early signs of heart failure due to inadequate cardiac output. Periorbital edema, while a sign of excess fluid, typically occurs earlier in the progression of heart failure compared to peripheral edema.

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