Nursing Elites

1. A major developmental milestone of a toddler is the achievement of autonomy. What should the caregiver instruct the parents to do to enhance their toddler’s need for autonomy?

• A. Teach the child to share with others.
• B. Help the child learn society’s roles.
• C. Teach the child to accept external limits.
• D. Help the child develop internal controls.

Correct answer: D

Rationale: Toddlers are striving for autonomy during this developmental stage. Helping the child to develop internal controls, such as self-regulation and decision-making skills, enhances their sense of autonomy. Choice A, teaching the child to share, focuses more on social skills rather than autonomy. Choice B, helping the child learn society's roles, pertains to socialization rather than autonomy. Choice C, teaching the child to accept external limits, is about compliance with rules rather than fostering autonomy. Therefore, the most appropriate action to enhance a toddler's need for autonomy is to help them develop internal controls.

2. You are called to a residence for a 'sick' 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of

• A. 100% oxygen via a non-rebreathing mask and rapid transport
• B. positive pressure ventilations with a BVM device and rapid transport
• C. chest compressions, artificial ventilations, and rapid transport
• D. back blows and chest thrusts while attempting artificial ventilations

Correct answer: C

Rationale: In a 5-year-old child who is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min, the priority is to initiate chest compressions, artificial ventilations, and rapid transport. These vital interventions are crucial in cases of severe respiratory and cardiovascular compromise. Choice A is incorrect because administering 100% oxygen alone may not address the underlying issues of inadequate ventilation and circulatory support. Choice B is not the most appropriate initial intervention in this scenario; chest compressions should precede positive pressure ventilations. Choice D is incorrect as back blows and chest thrusts are indicated in choking emergencies, not in this case of respiratory and cardiovascular compromise.

3. When describing urticaria, what would an instructor include?

• A. It is a type IV hypersensitivity reaction.
• B. Histamine release leads to vasodilation.
• C. Wheals appear first followed by erythema.
• D. The nonpruritic rash blanches with pressure.

Correct answer: B

Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction where histamine release leads to vasodilation and the formation of characteristic wheals. Choice A is incorrect as urticaria is associated with type I hypersensitivity, not type IV. Choice C is incorrect because in urticaria, erythema typically appears before the development of wheals. Choice D is incorrect as urticaria is typically pruritic and does not blanch with pressure.

4. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order?

• A. Corticosteroids.
• B. Antifungals.
• C. Antibiotics.
• D. Retinoids.

Correct answer: B

Rationale: The correct answer is B: Antifungals. Candidal diaper rash is caused by a yeast infection and is best treated with antifungal agents. Corticosteroids (choice A) may worsen fungal infections by suppressing the immune response. Antibiotics (choice C) are used to treat bacterial infections, not fungal infections like candidal diaper rash. Retinoids (choice D) are not typically used to treat candidal diaper rash in infants; they are more commonly used for dermatological conditions like acne.

5. While assessing an 18-month-old child, a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright. What does this action indicate to the nurse?

• A. Presence of talipes equinovarus
• B. Reflective of neurologic damage
• C. Expected behavior in a toddler of this age
• D. Existence of developmental dysplasia of the hip

Correct answer: C

Rationale: At 18 months of age, needing assistance to climb stairs upright is considered normal behavior for a toddler. Crawling upstairs is a different motor skill and does not necessarily correlate with the ability to climb stairs. The child is still developing gross motor skills, and climbing stairs upright typically requires more coordination and strength, which may not be fully developed at this age. Choices A, B, and D are not relevant in this scenario as the observed behavior is within the expected range of development for an 18-month-old child.

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