Nursing Elites

1. A parent is receiving discharge teaching following their infant's hypospadias repair. Which instruction should the parent follow?

• A. Apply a warm compress to the infant's surgical site twice daily.
• B. Avoid giving the infant a tub bath for 1 week.
• C. Apply an antibiotic ointment to the infant's penis daily.
• D. Clamp the infant's catheter for 30 minutes every 4 hours.

Correct answer: B

Rationale: After hypospadias repair, it is essential to avoid giving the infant a tub bath for 1 week to prevent infection and promote proper healing. Submerging the surgical site in water too soon can increase the risk of infection and compromise the healing process.

2. While caring for four different pediatric clients, which child is at the highest risk for dehydration?

• A. 7-year-old child with migraine headaches
• B. 4-year-old child with a broken arm
• C. 2-year-old child with cellulitis of the left leg
• D. 18-month-old child with tachypnea

Correct answer: D

Rationale: The 18-month-old child with tachypnea is at the highest risk for dehydration due to increased insensible water loss associated with rapid breathing.

3. A school-age child is 2 hours postoperative following a tonsillectomy. Which of the following actions should the nurse include in the plan of care?

• A. Place a heating pad at the surgical site.
• B. Encourage the child to cough every 2 hours.
• C. Administer analgesics to the child on a regular schedule.
• D. Apply an ice collar to the child's neck.

Correct answer: D

Rationale: After a tonsillectomy, applying an ice collar to the child's neck helps decrease pain and swelling. Heat should be avoided as it can increase bleeding. Encouraging coughing may increase the risk of bleeding. Administering analgesics on a regular schedule is essential for pain management, but the immediate postoperative period may require additional interventions like ice collar application.

4. Which frame of reference emphasizes techniques to teach children movement that resemble coaching?

• A. Motor control/motor learning
• B. Rehabilitation
• C. Biomechanical
• D. Ayres' sensory integration

Correct answer: A

Rationale: The correct frame of reference that emphasizes techniques to teach children movement resembling coaching is Motor control/motor learning. This approach focuses on improving movement skills through techniques that are similar to coaching methods. It helps children develop and refine their motor skills in a structured and goal-oriented manner. Rehabilitation, Biomechanical, and Ayres' sensory integration have different emphases and objectives in therapy, making them incorrect choices for this question.

5. The nurse is teaching a patient with cancer about a new prescription for a fentanyl patch, 25mcg/hr. for chronic back pain. Which statement is the most appropriate to include in the teaching plan.

• A. You will need to change this patch every day, regardless of your pain level.
• B. This type of pain medication is not as likely to cause breathing problems.
• C. With the first patch, it will take about 24hrs before you feel the full effects.
• D. Use your heating pad for the back pain. It will also improve the patch�s effectiveness.

Correct answer: C

Rationale: Full analgesic effects can take up to 24 hours to develop with fentanyl patches. Most patches are changed every 72 hours. Has the same adverse effects as other opioids, including respiratory depression. Should avoid exposing the patch to external heat sources, because this may increase toxicity.

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