Nursing Elites

1. A child with a diagnosis of hemophilia is admitted to the hospital with a bleeding episode. What is the priority nursing intervention?

• A. Administering pain medication
• B. Monitoring for signs of infection
• C. Administering factor VIII
• D. Ensuring a safe environment

Correct answer: C

Rationale: The correct answer is administering factor VIII. Hemophilia is a genetic disorder characterized by a deficiency in clotting factors, such as factor VIII. Administering factor VIII is crucial in managing bleeding episodes in hemophiliac patients. Pain medication (Choice A) may be necessary but is not the priority in this situation. Monitoring for signs of infection (Choice B) is important for overall care but is not the priority during a bleeding episode. Ensuring a safe environment (Choice D) is also important but not the priority intervention when managing a bleeding episode in a child with hemophilia.

2. After a discussion with the health care provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?

• A. The diameter of the aorta is enlarged.
• B. The wall between the right and left ventricles is open.
• C. It is a narrowing of the entrance to the pulmonary artery.
• D. It is a connection between the pulmonary artery and the aorta.

Correct answer: D

Rationale: The correct answer is D: 'It is a connection between the pulmonary artery and the aorta.' Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta, which normally closes after birth. Choices A, B, and C describe different cardiac conditions and do not accurately define PDA. Choice A is incorrect because PDA does not involve the diameter of the aorta being enlarged. Choice B is incorrect because PDA does not involve the wall between the right and left ventricles being open. Choice C is incorrect because PDA is not a narrowing of the entrance to the pulmonary artery.

3. Which of the following signs or symptoms is more common in children than adults following head trauma?

• A. nausea and vomiting
• B. altered mental status
• C. tachycardia and diaphoresis
• D. changes in pupillary reaction

Correct answer: A

Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less space for swelling within the skull compared to adults, making them more prone to experiencing symptoms like nausea and vomiting. Altered mental status and changes in pupillary reaction can also occur in both children and adults following head trauma, but they are not specifically more common in children. Tachycardia and diaphoresis are generally signs of autonomic nervous system activation and may occur in both children and adults, but they are not typically more common in children compared to adults following head trauma.

4. 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.

5. A healthcare provider is assessing a child with suspected bacterial meningitis. What is a common clinical manifestation that the provider is likely to observe?

• A. Rash
• B. Photophobia
• C. Jaundice
• D. Kernig sign

Correct answer: D

Rationale: A common clinical manifestation of bacterial meningitis is a positive Kernig sign, which indicates meningeal irritation. Kernig sign is elicited when the leg is bent at the hip and knee at 90-degree angles, and pain and resistance are felt with extension at the knee due to inflamed meninges. Options A, B, and C are not typically associated with bacterial meningitis. A rash is more commonly seen in viral illnesses, photophobia can be present but is not specific to bacterial meningitis, and jaundice is not a typical clinical manifestation of this condition.

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