Nursing Elites

1. A child with a diagnosis of sickle cell anemia is admitted to the hospital with a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, the priority nursing intervention is administering pain medication to alleviate the severe pain associated with the crisis. While administering oxygen can help improve oxygenation, pain relief is crucial in managing the crisis. Monitoring fluid intake is important in sickle cell anemia but is not the most immediate intervention during a vaso-occlusive crisis. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can exacerbate pain and complications.

2. A school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?

• A. Varicella (Chickenpox)
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.

3. When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to

• A. ask the patient to sign a release form
• B. ask a female EMT-B to attempt to assess the patient
• C. explain to the patient that she must be examined
• D. transport the patient without performing an assessment

Correct answer: B

Rationale: In this scenario, the patient has requested not to be touched, indicating a need for sensitivity and understanding. Asking a female EMT-B to attempt to assess the patient is the most appropriate initial action as it respects the patient's need for privacy, comfort, and potentially reduces re-traumatization. Asking the patient to sign a release form (Choice A) is not suitable as it disregards the patient's immediate concerns. Explaining to the patient that she must be examined (Choice C) may further distress her and violate her autonomy. Transporting the patient without performing an assessment (Choice D) ignores the patient's expressed wishes and may lead to inadequate care.

4. A 34-year-old woman, who is 36 weeks pregnant, is having a seizure. After you protect her airway and ensure adequate ventilation, you should transport her

• A. on her left side
• B. in the prone position
• C. in the supine position
• D. in a semi-sitting position

Correct answer: A

Rationale: Transporting a pregnant woman who is having a seizure on her left side is crucial as it helps improve blood flow to the fetus and reduces the risk of further complications. Placing her in the prone position or supine position may compromise blood flow to the fetus and worsen the situation. A semi-sitting position is also not recommended as it may not provide optimal blood flow to the fetus or adequately protect the airway during a seizure.

5. When teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration, what should the nurse emphasize?

• A. Rotate injection sites
• B. Administer insulin before meals
• C. Store insulin in the refrigerator
• D. Administer insulin at bedtime

Correct answer: A

Rationale: The correct answer is to rotate injection sites. This practice helps prevent lipodystrophy, a localized loss of fat tissue that can affect insulin absorption. By rotating sites, the child can avoid developing lumps or indentations in the skin where insulin is repeatedly injected. Administering insulin before meals (choice B) may be necessary for certain types of insulin but is not the priority when teaching about insulin administration. Storing insulin in the refrigerator (choice C) is important for maintaining its potency, but it is not the primary emphasis when teaching about insulin administration. Administering insulin at bedtime (choice D) may be necessary based on the child's insulin regimen but is not the primary consideration for teaching injection techniques and site rotation.

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