Nursing Elites

1. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?

• A. Bulging fontanels
• B. Stiff lower extremities
• C. Abnormal heart sounds
• D. Unusual pupillary reactions

Correct answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.

2. A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?

• A. Tetanus
• B. Influenza
• C. Scarlet fever
• D. Rheumatic fever

Correct answer: D

Rationale: Rheumatic fever is the most concerning illness in this case. It can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. If not properly treated, rheumatic fever can lead to serious complications such as inflamed joints and heart infections. Tetanus is caused by a toxin produced by Clostridium tetani bacteria and is not related to the symptoms described in the scenario. Influenza is a viral respiratory illness and does not typically lead to rheumatic fever. While scarlet fever is also caused by streptococcus bacteria, in this case, the symptoms described are more indicative of rheumatic fever than scarlet fever.

3. What should be included in the preoperative teaching for a 4-year-old child scheduled for a tonsillectomy?

• A. Explaining the procedure in detail
• B. Encouraging deep breathing exercises
• C. Discussing the importance of hydration
• D. Using play therapy to prepare the child

Correct answer: B

Rationale: Encouraging deep breathing exercises is important preoperative teaching for a child scheduled for a tonsillectomy. Deep breathing exercises can help the child relax and reduce anxiety, which is beneficial before the procedure. Explaining the procedure in detail might be overwhelming for a 4-year-old, whereas encouraging deep breathing exercises can be more beneficial in promoting relaxation and preparing the child. Discussing the importance of hydration is crucial for postoperative care but may not be the priority for preoperative teaching. Using play therapy can help prepare the child, but encouraging deep breathing exercises is more directly related to relaxation and preparation for the procedure.

4. What is an essential nursing action when caring for a young child with severe diarrhea?

• A. Maintain the IV.
• B. Take daily weights.
• C. Replace the lost calories.
• D. Promote perianal skin integrity.

Correct answer: D

Rationale: Promoting perianal skin integrity is crucial when caring for a young child with severe diarrhea to prevent skin breakdown from the irritation caused by frequent bowel movements. Maintaining the IV (Choice A) may be important for hydration but is not directly related to managing skin integrity. Taking daily weights (Choice B) is important for monitoring fluid balance but does not address the immediate need to prevent skin breakdown. While replacing lost calories (Choice C) is important, it is not the priority when a child is experiencing severe diarrhea and skin integrity is at risk.

5. What should the nurse include when teaching an adolescent about tinea pedis?

• A. Keep your feet moist and open to the air as much as possible.
• B. Dry the area between your toes thoroughly.
• C. Wear nylon or synthetic socks every day.
• D. Go barefoot when you are in the school locker room.

Correct answer: B

Rationale: The correct way to prevent tinea pedis is by keeping the feet dry, especially between the toes, to decrease the risk of fungal infection. Choice A is incorrect as keeping the feet moist can promote fungal growth. Choice C is incorrect because nylon or synthetic socks can trap moisture, contributing to the growth of fungi. Choice D is incorrect as going barefoot in public, especially in areas like locker rooms, increases the risk of contracting tinea pedis.

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