Nursing Elites

1. A child with a diagnosis of leukemia is admitted to the hospital with a fever. What is the priority nursing intervention?

• A. Administering antibiotics
• B. Administering antipyretics
• C. Providing nutritional support
• D. Monitoring for signs of infection

Correct answer: D

Rationale: The correct answer is D: Monitoring for signs of infection. When a child with leukemia presents with a fever, the priority nursing intervention is to monitor for signs of infection due to the immunocompromised state of the child. Administering antibiotics (choice A) may be necessary based on the assessment of signs of infection, but monitoring comes first. Administering antipyretics (choice B) helps to reduce fever but does not address the underlying cause. Providing nutritional support (choice C) is essential but not the priority when the child is at risk of infection.

2. A nurse is providing care to a child diagnosed with sickle cell anemia. What is the priority nursing intervention?

• A. Administering pain medication
• B. Ensuring adequate hydration
• C. Providing nutritional support
• D. Monitoring vital signs

Correct answer: A

Rationale: In sickle cell anemia, pain management is a priority due to vaso-occlusive crises that cause severe pain. Administering pain medication helps alleviate discomfort and improve the child's quality of life. Ensuring adequate hydration, although important, is secondary to addressing the immediate pain issue. Providing nutritional support is beneficial for overall health but does not address the acute pain experienced. Monitoring vital signs is essential but not the immediate priority when managing pain in sickle cell anemia.

3. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect when palpating the infant’s abdomen?

• A. A distended colon
• B. Marked tenderness around the umbilicus
• C. An olive-sized mass in the right upper quadrant
• D. Rhythmic peristaltic waves in the lower abdomen

Correct answer: C

Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS due to the hypertrophied pylorus muscle. Choices A, B, and D are incorrect. A distended colon is not typically associated with HPS. Marked tenderness around the umbilicus is not a specific finding of HPS. Rhythmic peristaltic waves in the lower abdomen are not expected in HPS, as the condition primarily affects the pylorus region of the stomach.

4. The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?

• A. Interrupted family process related to the child's diagnosis
• B. Deficient knowledge related to the genetic disorder
• C. Grieving related to the child's poor prognosis
• D. Ineffective coping related to stress from providing care

Correct answer: C

Rationale: The correct nursing diagnosis would be 'Grieving related to the child's poor prognosis.' Trisomy 18 is associated with a poor prognosis, and families often experience feelings of grief and loss when dealing with such a diagnosis. The choice 'Interrupted family process' does not directly address the emotional response to the prognosis. 'Deficient knowledge' may be a concern but does not address the emotional aspect of dealing with a poor prognosis. 'Ineffective coping related to stress from providing care' focuses more on the caregiver's ability to cope rather than the family's response to the child's condition.

5. When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school’s Parent-Teachers Association?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.

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