Nursing Elites

1. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?

• A. Child is in the concrete operational stage of cognition.
• B. Child’s dependence on peer influence is increasing.
• C. Child will welcome opportunities for participation in self-care.
• D. Child’s developmental stage involves achieving a sense of autonomy.

Correct answer: C

Rationale: The correct answer is C. At the age of 8, children are typically in the stage of industry vs. inferiority according to Erikson's psychosocial theory. This stage is characterized by a desire to engage in productive activities and take on responsibilities. Thus, the child will likely welcome opportunities for participation in self-care related to their diabetes management. Choices A, B, and D are incorrect. Choice A is inaccurate as children at this age are usually in the concrete operational stage of cognitive development, not abstract. Choice B is incorrect because while peer influence is significant, it has not reached its peak at this age. Choice D is wrong as achieving a sense of identity is a developmental task more commonly associated with adolescence, not 8-year-old children.

2. A parent arrives in the emergency clinic with a 3-month-old baby who has difficulty breathing and prolonged periods of apnea. Which assessment data should alert the nurse to suspect shaken baby syndrome (SBS)?

• A. Birth occurred before 32 weeks’ gestation
• B. Lack of stridor and adventitious breath sounds
• C. Previous episodes of apnea lasting 10 to 15 seconds
• D. Retractions and use of accessory respiratory muscles

Correct answer: D

Rationale: Retractions and the use of accessory respiratory muscles are signs of respiratory distress in infants. These clinical manifestations can be associated with trauma, such as shaken baby syndrome (SBS), which can lead to severe head injuries and respiratory compromise. Birth before 32 weeks’ gestation (Choice A) is more related to prematurity complications rather than SBS. The absence of stridor and adventitious breath sounds (Choice B) may not be specific indicators of SBS. Previous episodes of apnea lasting 10 to 15 seconds (Choice C) alone may not be as concerning as the presence of retractions and use of accessory muscles in the context of a distressed infant.

3. A child with a diagnosis of bronchiolitis is admitted to the hospital. What is the most important nursing intervention?

• A. Administering bronchodilators
• B. Providing respiratory therapy
• C. Monitoring oxygen saturation
• D. Encouraging fluid intake

Correct answer: B

Rationale: The most important nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention helps to maintain airway patency and improve breathing, which are crucial in managing bronchiolitis. Administering bronchodilators (Choice A) may be a part of the treatment plan but is not the most important intervention. Monitoring oxygen saturation (Choice C) is important but falls secondary to providing direct respiratory support. Encouraging fluid intake (Choice D) is also essential but does not address the immediate respiratory needs of the child with bronchiolitis.

4. A child who had surgery for a congenital heart defect is being discharged. What is an important aspect of the discharge teaching?

• A. Teaching the parents about signs of infection
• B. Providing instructions on wound care
• C. Scheduling follow-up appointments
• D. Explaining the use of prescribed medications

Correct answer: D

Rationale: Explaining the use of prescribed medications is crucial as it helps ensure the proper management of the child's condition post-discharge. Understanding how and when to administer medications is essential for the child's recovery. While teaching the parents about signs of infection, providing wound care instructions, and scheduling follow-up appointments are also important aspects of care, ensuring the correct use of prescribed medications takes precedence to prevent complications and promote the child's well-being.

5. What behavior does the nurse anticipate when feeding a newborn with choanal atresia?

• A. Chokes during feeding
• B. Experiences swallowing challenges
• C. Lacks hunger cues
• D. Takes about half of the feeding

Correct answer: D

Rationale: When feeding a newborn with choanal atresia, the nurse can anticipate that the infant may take only part of the feeding before pausing for air. This is due to the fact that infants with choanal atresia struggle to breathe through their nose while feeding. Choice A is incorrect as choking typically involves a more severe airway obstruction. Choice B is incorrect because difficulty swallowing is not the primary concern in choanal atresia. Choice C is incorrect as the issue is not related to hunger cues but rather the physiological challenges associated with breathing while feeding.

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