Nursing Elites

1. According to Piaget, which principle supports a nine-year-old child's understanding that an arm will look the same when the IV is removed?

• A. The principle of conservation
• B. The principle of transductive reasoning
• C. The principle of identity
• D. The principle of reflex abilities

Correct answer: A

Rationale: The correct answer is A, the principle of conservation. Piaget's principle of conservation relates to a child's ability to understand that certain properties of objects remain unchanged despite modifications in their appearance. In this case, the child's understanding that an arm will look the same after the IV is removed demonstrates conservation of appearance. Choice B, transductive reasoning, involves making faulty generalizations based on specific instances and does not apply in this context. Choice C, the principle of identity, pertains to recognizing objects as the same even if they undergo transformations, which is not directly relevant to the scenario. Choice D, reflex abilities, refers to automatic responses to stimuli and is unrelated to the child's understanding of the arm's appearance post-IV removal.

2. The nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?

• A. 0.9% normal saline
• B. D5 0.2% (1/4) normal saline
• C. D5W
• D. Albumin

Correct answer: A

Rationale: In the case of severe isotonic dehydration, the initial fluid of choice is 0.9% normal saline. This solution is preferred because it helps to restore both fluids and electrolytes effectively. Options B, C, and D are not suitable for the initial management of severe isotonic dehydration. D5 0.2% (1/4) normal saline (Choice B) is a hypotonic solution and might worsen the imbalance. D5W (Choice C) is a hypotonic solution that does not contain electrolytes essential for rehydration. Albumin (Choice D) is a colloid solution used for specific indications like hypoproteinemia or hypoalbuminemia, not for initial rehydration in severe dehydration.

3. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

• A. Keep buttons, beads, and other small objects out of his reach.
• B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
• C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
• D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.

Correct answer: A

Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.

4. What is the first-line treatment for a febrile seizure in a child?

• A. Antipyretics
• B. Anticonvulsants
• C. Cooling blankets
• D. IV fluids

Correct answer: A

Rationale: The correct answer is Antipyretics. Febrile seizures in children are usually associated with fever. The first-line treatment aims to reduce fever, which can help prevent febrile seizures. Antipyretics like acetaminophen or ibuprofen are commonly used for this purpose. Anticonvulsants, while used for treating seizures, are not typically the first-line treatment for febrile seizures as they are usually self-limited and resolve on their own. Cooling blankets can be used to lower body temperature in cases of hyperthermia but are not the primary treatment for febrile seizures. IV fluids may be administered in cases of dehydration due to fever or if the child cannot tolerate oral intake, but they are not the first-line treatment for febrile seizures.

5. What is the earliest age at which a satisfactory radial pulse can be taken in children?

• A. 1 year
• B. 2 years
• C. 3 years
• D. 6 years

Correct answer: C

Rationale: A satisfactory radial pulse can typically be taken starting at around 3 years of age, as younger children often have pulses that are too fast and irregular for accurate measurement.

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