Nursing Elites

1. During a primary survey of a child with partial thickness burns over the upper body areas, what action should the nurse take first?

• A. Inspect the child's skin color.
• B. Assess for a patent airway.
• C. Observe for symmetric breathing.
• D. Palpate the child's pulse.

Correct answer: B

Rationale: When managing a child with partial thickness burns over the upper body areas, the priority action during the primary survey is to assess for a patent airway. This step is crucial as burns in this region can lead to airway compromise, potentially causing rapid deterioration in the child's condition. Checking for a patent airway ensures that the child can breathe adequately, which is essential for oxygenation and ventilation. Inspecting the child's skin color (Choice A) is an important assessment but should follow ensuring a patent airway. Observing for symmetric breathing (Choice C) is relevant, but the immediate focus should be on securing the airway. Palpating the child's pulse (Choice D) is also a vital assessment, but in this scenario, the priority is to assess and maintain a clear airway to support respiratory function and oxygen delivery.

2. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?

• A. Erythematous papulovesicular rash
• B. Dry, red, scaly rash with lichenification
• C. Pustular vesicles with honey-colored exudates
• D. Hypopigmented oval scaly lesions

Correct answer: B

Rationale: In atopic dermatitis, the nurse would expect to observe a dry, red, scaly rash with lichenification. Lichenification is thickened skin due to chronic scratching. Choices A, C, and D are incorrect. Erythematous papulovesicular rash is more characteristic of contact dermatitis, pustular vesicles with honey-colored exudates are seen in impetigo, and hypopigmented oval scaly lesions are typical of pityriasis alba.

3. A parent calls the outpatient clinic requesting information about the appropriate dose of acetaminophen for a 16-month-old child who has signs of an upper respiratory tract infection and fever. The directions on the bottle of acetaminophen elixir are 120 mg every 4 hours when needed. At the toddler’s 15-month visit, the health care provider prescribed 150 mg. What is the nurse’s best response to the parent?

• A. “The dose is close enough, and it doesn’t really matter which one is given.”
• B. “From your description, the medications are not necessary. They should be avoided at this age.”
• C. “It is appropriate to use dosages based on age. Children typically have weights consistent for their age groups.”
• D. “The prescribed dose of the drug was based on weight, and this is a more accurate way of determining a therapeutic dose.”

Correct answer: D

Rationale: The most accurate way to determine a therapeutic dose for children is based on their weight rather than age. Weight-based dosing helps ensure that the child receives the appropriate amount of medication for their body size, which is crucial for safety and effectiveness. Age-based dosing can lead to underdosing or overdosing, as children of the same age can have significantly different weights. Choice A is incorrect because even small variations in dosages can have significant effects on a child's health. Choice B is incorrect as acetaminophen can be appropriate when used correctly for fever management in children. Choice C is incorrect as children's weights can vary greatly within the same age group, making weight-based dosing more precise and individualized.

4. The nurse is planning a discussion group for parents with children who have cancer. How would the nurse describe a difference between cancer in children and adults?

• A. Most childhood cancers affect tissues rather than organs.
• B. Childhood cancers are usually localized when found.
• C. Unlike adult cancers, childhood cancers are less responsive to treatment.
• D. The majority of childhood cancers can be prevented.

Correct answer: A

Rationale: The correct answer is A. Most childhood cancers, such as leukemias and sarcomas, affect tissues rather than specific organs, unlike many adult cancers. Choice B is incorrect because childhood cancers can be localized or spread, similar to adult cancers. Choice C is incorrect because childhood cancers can be highly responsive to treatment, especially when diagnosed early. Choice D is incorrect because the majority of childhood cancers cannot be prevented as they are often due to genetic mutations or unknown causes.

5. What is the priority nursing intervention for a child with a diagnosis of acute lymphoblastic leukemia (ALL) receiving chemotherapy?

• A. Preventing infection
• B. Administering chemotherapy
• C. Providing nutritional support
• D. Monitoring fluid intake

Correct answer: A

Rationale: The correct answer is A: Preventing infection. When caring for a child with acute lymphoblastic leukemia (ALL) undergoing chemotherapy, the top priority is to prevent infection. Chemotherapy suppresses the immune system, making the child more susceptible to infections. By implementing infection control measures such as hand hygiene, aseptic techniques, and environmental cleanliness, the nurse can help protect the child from potentially life-threatening infections. Administering chemotherapy (choice B) is important but not the priority over preventing infection. Providing nutritional support (choice C) and monitoring fluid intake (choice D) are essential aspects of care but take a back seat to preventing infection in this scenario.

Similar Questions