Nursing Elites

1. A nurse is caring for a child with a diagnosis of acute lymphoblastic leukemia (ALL). What is the priority nursing intervention?

• A. Administering chemotherapy
• B. Preventing infection
• C. Monitoring for signs of bleeding
• D. Providing nutritional support

Correct answer: A

Rationale: The correct answer is A: Administering chemotherapy. In the care of a child with acute lymphoblastic leukemia (ALL), the priority nursing intervention is administering chemotherapy. Chemotherapy is the primary treatment for ALL and plays a crucial role in managing the disease. While preventing infection, monitoring for signs of bleeding, and providing nutritional support are important aspects of caring for a child with ALL, administering chemotherapy takes precedence as it directly targets the cancer cells and aims to induce remission.

2. What behavior does the nurse anticipate while feeding a newborn with choanal atresia?

• A. Chokes on the feeding
• B. Has difficulty swallowing
• C. Does not appear to be hungry
• D. Takes about half of the feeding

Correct answer: D

Rationale: Correct answer: When feeding a newborn with choanal atresia, the nurse should anticipate that the infant may take only part of the feeding. This behavior is due to the condition causing difficulty in breathing through the nose while feeding, prompting the infant to pause for air. Choice A, 'Chokes on the feeding,' is incorrect as it does not specifically relate to the feeding behavior expected in choanal atresia. Choice B, 'Has difficulty swallowing,' is also incorrect because the issue in choanal atresia is primarily related to breathing rather than swallowing. Choice C, 'Does not appear to be hungry,' is not the typical behavior seen in infants with choanal atresia; they may still display hunger cues but struggle with feeding due to the condition.

3. What is an early sign of congestive heart failure that the nurse should recognize?

• A. tachypnea
• B. bradycardia
• C. inability to sweat
• D. increased urinary output

Correct answer: A

Rationale: Tachypnea is an early sign of congestive heart failure that nurses should recognize. Tachypnea refers to rapid breathing, which can be an indication of the body's attempt to compensate for decreased cardiac output in congestive heart failure. Bradycardia (choice B) is a slow heart rate and is not typically associated with congestive heart failure. Inability to sweat (choice C) and increased urinary output (choice D) are not specific early signs of congestive heart failure and are not typically recognized as such.

4. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?

• A. Dislocated radial head
• B. Transient synovitis of the hip
• C. Osgood-Schlatter disease
• D. Scoliosis

Correct answer: C

Rationale: Osgood-Schlatter disease is a common overuse injury that specifically affects the knee. It is characterized by inflammation of the patellar ligament at the tibial tuberosity due to repetitive strain on the growth plate during activities such as running and jumping. Dislocated radial head (Choice A) is not an overuse disorder but rather an injury usually seen in young children. Transient synovitis of the hip (Choice B) is an acute hip condition and not typically classified as an overuse disorder. Scoliosis (Choice D) is a condition characterized by an abnormal lateral curvature of the spine and is not considered an overuse disorder.

5. What is an early sign of congestive heart failure that the nurse should recognize?

• A. Tachypnea
• B. Bradycardia
• C. Inability to sweat
• D. Increased urinary output

Correct answer: A

Rationale: Tachypnea, which refers to rapid breathing, is an early sign of congestive heart failure. In heart failure, the heart's inability to pump efficiently can lead to fluid accumulation in the lungs, causing the child to breathe faster to try to compensate for the decreased oxygen exchange. Bradycardia (slow heart rate) is not typically associated with congestive heart failure; instead, it may indicate a different issue. Inability to sweat is not a common early sign of congestive heart failure. Increased urinary output is not a typical early sign of congestive heart failure; instead, it may be a sign of other conditions like diabetes or kidney issues.

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