Nursing Elites

1. When evaluating a child with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) 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 as certain foods and additives can affect ADHD symptoms. Ensuring a balanced diet can help manage symptoms and provide proper nutrition. Assessing sleep patterns (Choice A) is also important, but dietary intake is more directly linked to symptom management in ADHD. Academic performance (Choice C) and behavior at home (Choice D) may be affected by ADHD but are not as directly related to medication management as dietary intake.

2. During the second week of hospitalization for intravenous antibiotic therapy, a 2-year-old toddler whose family is unable to visit often smiles easily, goes to all the nurses happily, and does not express interest in the parent when the parent does visit. The parent tells the nurse, 'I am pleased about the adjustment but somewhat concerned about my child’s reaction to me.' How should the nurse respond?

• A. The child is repressing feelings towards the parent.
• B. Routines have been established, and the child feels safe.
• C. The child has given up fighting and accepts the separation.
• D. Behavior has improved because the child feels better physically.

Correct answer: C

Rationale: The correct answer is C. The child's behavior of smiling easily, interacting happily with nurses, and showing disinterest in the parent when they visit indicates that the child has emotionally withdrawn and accepted the separation. This response suggests that the child may have given up fighting against the separation from the parent due to prolonged hospitalization. Choices A, B, and D are incorrect. Choice A about the child repressing feelings towards the parent is not supported by the scenario. Choice B about routines and feeling safe does not address the emotional aspect of the child's behavior. Choice D about improved behavior due to feeling better physically does not explain the emotional dynamics at play in the child's behavior.

3. A child is admitted with extensive burns. The nurse notes burns on the child’s lips and singed nasal hairs. The nurse should suspect that the child has a(n)

• A. chemical burn
• B. inhalation injury
• C. electrical burn
• D. hot-water scald

Correct answer: B

Rationale: Burns on the lips and singed nasal hairs are indicative of an inhalation injury. This suggests that the child has likely inhaled hot gases or smoke, leading to damage in the respiratory tract. Choice A, chemical burn, is incorrect because the symptoms described are more aligned with inhalation rather than direct contact with chemicals. Choice C, electrical burn, is incorrect as there are no mentions of contact with an electrical source. Choice D, hot-water scald, is also incorrect as the presentation of burns on the lips and singed nasal hairs is not characteristic of scald injuries.

4. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?

• A. Encourage a high-protein diet
• B. Avoid foods high in salt
• C. Encourage a low-sodium diet
• D. Encourage a low-protein diet

Correct answer: B

Rationale: For a child with nephrotic syndrome, it is crucial to avoid foods high in salt to manage symptoms and prevent complications. Excessive salt intake can lead to fluid retention and exacerbate edema, which are common issues in nephrotic syndrome. Encouraging a high-protein diet (Choice A) may put additional strain on the kidneys and worsen the condition. While protein restriction is sometimes needed, it is not the primary dietary concern in nephrotic syndrome. Similarly, a low-protein diet (Choice D) is not typically recommended as it may lead to malnutrition in children. Although a low-sodium diet (Choice C) may sound similar to avoiding foods high in salt, the emphasis should be on reducing salt intake specifically, rather than a generalized low-sodium approach.

5. A home care nurse is visiting a family for the first time. The 4-week-old infant had surgery for exstrophy of the bladder and creation of an ileal conduit soon after birth. When the nurse arrives, the mother appears tired, and the baby is crying. After an introduction, which is the most appropriate statement by the nurse?

• A. “Tell me about your daily routine.”
• B. “You look tired. Is everything alright?”
• C. “When was the last time the baby had a bottle?”
• D. “Oh, it looks like you two are having a bad day.”

Correct answer: A

Rationale: Asking about the daily routine is the most appropriate statement by the nurse in this scenario. It allows the nurse to gather important information about the family's schedule, feeding patterns, and overall care routine for the infant. This open-ended question helps the nurse assess the family's situation comprehensively and identify any areas where support may be needed. Choices B, C, and D are less appropriate as they do not focus on gathering relevant information about the family's routine and needs but rather make assumptions or ask about specific isolated events.

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