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. 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.

3. The caregiver is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the caregiver indicates a need for further teaching?

• A. I need to avoid pushing or pulling on an arm or leg.
• B. I should carefully lift the baby by supporting the head and neck.
• C. I should not bend an arm or leg into an awkward position.
• D. We must avoid lifting the legs by the ankles to change diapers.

Correct answer: B

Rationale: Lifting the baby by supporting the head and neck can cause fractures in infants with osteogenesis imperfecta. Caregivers should avoid lifting infants in this manner due to the risk of injury. Choices A, C, and D demonstrate correct understanding of how to prevent injuries in infants with osteogenesis imperfecta by avoiding excessive force on the arms or legs, preventing awkward positions, and lifting the legs in a safer manner to change diapers.

4. A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?

• A. Administering a bronchodilator
• B. Administering an antihistamine
• C. Administering a corticosteroid
• D. Administering oxygen

Correct answer: A

Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways quickly, providing immediate relief by opening up the narrowed air passages in asthma. Antihistamines are not the first-line treatment for asthma exacerbations and may not address the underlying bronchoconstriction. Corticosteroids are important for long-term control of asthma but may take longer to have an effect compared to bronchodilators. Administering oxygen is essential for hypoxemia in asthma exacerbations, but the priority is to relieve bronchoconstriction promptly with a bronchodilator.

5. Why does a cleft lip predispose an infant to infection, concerning a nurse caring for the infant?

• A. Waste products accumulate along the defect.
• B. There is inadequate circulation in the defective area.
• C. Nutrition is inadequate due to ineffective feeding.
• D. Mouth breathing dries the oropharyngeal mucous membranes.

Correct answer: D

Rationale: Mouth breathing due to a cleft lip can dry the mucous membranes, increasing their susceptibility to infection. While waste product accumulation (Choice A) and inadequate circulation (Choice B) may contribute to complications, they are not directly related to infection in this context. Inadequate nutrition (Choice C) may affect overall health but is not the primary reason for infection predisposition in this case.

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