Nursing Elites

1. A four-year-old child has a history of repeated otitis media despite antibiotic treatment. Which treatment measure should the nurse discuss with the parents?

• A. Antibiotic treatment
• B. Adenoidectomy
• C. The insertion of tympanostomy (pressure equalizing) tubes
• D. Tonsillectomy

Correct answer: C

Rationale: The correct answer is C: The insertion of tympanostomy (pressure equalizing) tubes. This treatment measure is appropriate for a child with recurrent otitis media as it helps drain fluid from the middle ear and prevent further infections. Adenoidectomy (choice B) involves the removal of the adenoids, which may not directly address the ear infections. Antibiotic treatment (choice A) has already been ineffective in this case, so alternative measures are necessary. Tonsillectomy (choice D) is not typically indicated for otitis media unless there are specific reasons such as enlarged tonsils contributing to the condition.

2. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?

• A. The United States is ranked last among 27 countries
• B. The United States is ranked similar to 20 other developed countries
• C. The United States is ranked in the middle of 20 other developed countries
• D. The United States is ranked highest among 27 other industrialized countries

Correct answer: A

Rationale: The United States is ranked last among developed countries with similar populations in terms of infant mortality rates, highlighting a significant public health concern.

3. What is the primary treatment goal for a child with nephrotic syndrome?

• A. Reduce proteinuria
• B. Lower blood pressure
• C. Increase urine output
• D. Prevent infections

Correct answer: A

Rationale: The correct answer is A: Reduce proteinuria. In nephrotic syndrome, the primary treatment goal is to reduce proteinuria to prevent further kidney damage. Lowering blood pressure (choice B) is important in managing some types of kidney disease but is not the primary treatment goal in nephrotic syndrome. Increasing urine output (choice C) and preventing infections (choice D) are important aspects of supportive care but are not the primary treatment goal for nephrotic syndrome.

4. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

• A. Send the child to his or her room if the child has one.
• B. A general rule for length of time is 1 hour per year of age.
• C. Select an area that is safe and nonstimulating, such as a hallway.
• D. If the child cries, refuses, or is more disruptive, try another approach.

Correct answer: C

Rationale: Time-outs should be in a safe, nonstimulating area, with the length typically being 1 minute per year of the child's age, not 1 hour.

5. What is the primary treatment goal for a child with juvenile idiopathic arthritis?

• A. Pain management
• B. Cure of the disease
• C. Reduction of joint deformity
• D. Physical therapy

Correct answer: A

Rationale: The primary treatment goal for a child with juvenile idiopathic arthritis is pain management. Juvenile idiopathic arthritis is a chronic condition with no known cure, making pain management crucial to improve the quality of life for these children. While reducing joint deformity and physical therapy are important aspects of managing the condition, the primary focus is on alleviating pain and improving function.

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