Nursing Elites

1. When caring for a child diagnosed with asthma, what is an important nursing intervention?

• A. Administering bronchodilators
• B. Encouraging physical activity
• C. Monitoring oxygen saturation
• D. Providing nutritional support

Correct answer: A

Rationale: Administering bronchodilators is a crucial nursing intervention for a child with asthma as it helps to open the airways and improve breathing. Bronchodilators work by relaxing the muscles around the airways, making breathing easier for the child. Encouraging physical activity may exacerbate asthma symptoms in some cases, so it is not recommended as a primary intervention. Monitoring oxygen saturation is important in assessing respiratory status, but administering bronchodilators would take precedence in this situation. Providing nutritional support is a general nursing intervention and not specific to managing asthma symptoms.

2. The parents of a 6-week-old infant who was born without an immune system ask a nurse why their baby is still so healthy. How should the nurse reply?

• A. Exposure to pathogens during this time can be limited.
• B. Some antibodies are produced by the infant’s colonic bacteria.
• C. Antibodies are passively received from the mother through the placenta and breast milk.
• D. Fewer antibodies are produced by the fetal thymus during the eighth and ninth months of gestation.

Correct answer: C

Rationale: The correct answer is C. Infants receive passive immunity through antibodies from the mother during pregnancy and breastfeeding, which protect them initially. Choice A is incorrect because a 6-week-old infant born without an immune system would not be able to limit exposure to pathogens effectively. Choice B is incorrect as antibodies produced by colonic bacteria are not a significant source of immunity in infants. Choice D is incorrect as the fetal thymus primarily plays a role in T cell development rather than antibody production during gestation.

3. A healthcare professional is reviewing the clinical records of infants and children with cardiac disorders who developed heart failure. What did the healthcare professional determine is the last sign of heart failure?

• A. Tachypnea
• B. Tachycardia
• C. Peripheral edema
• D. Periorbital edema

Correct answer: C

Rationale: Peripheral edema is often the last sign of heart failure in infants and children as it indicates significant fluid retention and circulatory compromise. Tachypnea (Choice A) and tachycardia (Choice B) are early signs of heart failure due to the body's compensatory mechanisms. Periorbital edema (Choice D) can occur in heart failure but is not typically the last sign; it is more commonly associated with renal or hepatic dysfunction.

4. A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?

• A. Dry, hacking cough
• B. Inspiratory stridor
• C. Nasal congestion
• D. Severe coughing spells

Correct answer: D

Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.

5. When preparing a 2-year-old child for surgery, what preoperative teaching should be provided to help them understand the procedure?

• A. Explaining the procedure in simple terms
• B. Using a doll to demonstrate the procedure
• C. Showing pictures of the hospital environment
• D. Allowing the child to play with medical equipment

Correct answer: B

Rationale: The correct preoperative teaching for a 2-year-old child undergoing surgery involves using a doll to demonstrate the procedure. This method helps the child understand what to expect in a non-threatening and visual way, making the experience less intimidating. Explaining the procedure in simple terms (Choice A) may not effectively convey the details to a young child. Showing pictures of the hospital environment (Choice C) may not directly address the surgical procedure itself. Allowing the child to play with medical equipment (Choice D) can be unsafe and may not effectively prepare the child for the surgery.

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