Nursing Elites

1. When explaining a viral disease that begins with malaise and a highly pruritic rash starting on the abdomen, spreading to the face and proximal extremities, and potentially leading to severe complications, which childhood disease is a nurse discussing with members of a grammar school’s Parent-Teachers Association?

• A. Rubella
• B. Rubeola
• C. Chickenpox
• D. Scarlet fever

Correct answer: C

Rationale: The correct answer is Chickenpox (varicella). This viral disease typically starts with malaise and a highly pruritic rash that begins on the abdomen and then spreads to the face and proximal extremities. Chickenpox can result in serious complications such as pneumonia and encephalitis. Rubella (German measles) presents with a milder rash and is less pruritic than chickenpox. Rubeola (measles) is characterized by a rash that spreads from the head to the trunk. Scarlet fever is caused by group A Streptococcus bacteria and is not a viral illness.

2. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?

• A. Remove small objects from the floor.
• B. Cover electric outlets with safety plugs.
• C. Remove toxic substances from low areas.
• D. Test the temperature of water before bathing.

Correct answer: D

Rationale: The correct answer is to test the temperature of water before bathing. This is crucial in preventing burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can be easily burned by water that is too hot. Removing small objects from the floor (Choice A) is important to prevent choking hazards but not directly related to burns. Covering electric outlets with safety plugs (Choice B) is essential to prevent electrocution but does not address the risk of burns specifically. Removing toxic substances from low areas (Choice C) is necessary to prevent poisoning but is not directly related to burns. Therefore, the priority in this scenario is to prevent burns by ensuring the water temperature is safe for the infant.

3. A child is being assessed for suspected intussusception. What clinical manifestation is the healthcare provider likely to observe?

• A. Projectile vomiting
• B. Currant jelly stools
• C. Abdominal distension
• D. Constipation

Correct answer: C

Rationale: The correct clinical manifestation the healthcare provider is likely to observe in a child with suspected intussusception is abdominal distension. Intussusception involves one portion of the intestine telescoping into another, causing obstruction. Abdominal distension is a common symptom due to the obstruction and buildup of gas and fluid in the affected area. While projectile vomiting can occur, it is not as specific to intussusception as abdominal distension. Currant jelly stools, which are stools containing blood and mucus, are a classic sign of intussusception but are not a clinical manifestation observable on assessment. Constipation is not typically associated with intussusception, as this condition often presents with symptoms of bowel obstruction rather than constipation.

4. At 2 years of age, a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience?

• A. Satisfying the child’s wishes
• B. Previous experience of hospitalization
• C. Preventing the child from being with strangers
• D. Ensuring the child still receives parental affection

Correct answer: B

Rationale: The most important factor in preparing a toddler for additional surgery is their previous experience of hospitalization. This familiarity can help reduce anxiety and fear associated with the hospital environment and medical procedures. Choice A, satisfying the child’s wishes, may not always be feasible or in the child's best interest during medical procedures. Choice C, preventing the child from being with strangers, may not address the core issue of preparing the child for surgery. Choice D, ensuring the child still receives parental affection, is important but may not directly address the preparation needed for surgery.

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

• A. Administering chemotherapy
• B. Preventing infection
• C. Monitoring for signs of bleeding
• D. Providing nutritional support

Correct answer: A

Rationale: The correct answer is A: Administering chemotherapy. In the care of a child with acute lymphoblastic leukemia (ALL), the priority nursing intervention is administering chemotherapy. Chemotherapy is the primary treatment for ALL and plays a crucial role in managing the disease. While preventing infection, monitoring for signs of bleeding, and providing nutritional support are important aspects of caring for a child with ALL, administering chemotherapy takes precedence as it directly targets the cancer cells and aims to induce remission.

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