Nursing Elites

1. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?

• A. Administer aspirin for pain.
• B. Avoid administering NSAIDs.
• C. Restrict physical activities.
• D. Apply heat to joints.

Correct answer: B

Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.

2. At what age may an infant close their eyes to bright lights and show improved head control?

• A. 30-33 weeks after conception
• B. 34-36 weeks after conception
• C. Less than 30 weeks after conception
• D. 37-40 weeks after conception

Correct answer: A

Rationale: Around 30-33 weeks after conception, infants usually start closing their eyes in response to bright lights and exhibit enhanced head control. This developmental milestone indicates progress in their visual and motor abilities, reflecting the maturation of their neurological system. As preterm infants continue to grow and develop, they gradually acquire these skills, showcasing the natural progression of their sensory and motor functions.

3. Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?

• A. The dialysate is clear upon return.
• B. The volume of drained dialysate is less than the volume infused.
• C. The child is restless and eager to play.
• D. The child's vital signs remain consistent with those noted during infusion.

Correct answer: B

Rationale: A lower volume of drained dialysate compared to the volume infused suggests a possible obstruction or malfunction in the dialysis process. This finding could compromise the effectiveness of the treatment and needs prompt assessment and intervention by the nurse to ensure the child's safety and well-being. Choices A, C, and D are not indicative of complications during peritoneal dialysis. The clarity of the dialysate, the child's behavior, and the consistency of vital signs are not alarming findings that would require immediate action by the nurse.

4. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?

• A. The child with tachypnea and pulmonary congestion
• B. The child with hepatomegaly and normal respiratory rate
• C. The child with dependent and sacral edema and regular pulse
• D. The child with periorbital edema and normal respiratory rate

Correct answer: A

Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.

5. Which question does not provide information regarding the family's cultural values?

• A. Who makes the decisions?
• B. What is the child's date of birth?
• C. What are the daily routines and rules of mealtime?
• D. What do the parents believe about disability?

Correct answer: B

Rationale: The correct answer is B. Asking for the child's date of birth is a factual question that does not directly relate to the family's cultural values. Choices A, C, and D delve into aspects that could offer insights into the family's cultural values and beliefs. Question A explores decision-making dynamics within the family, which can be influenced by cultural norms. Question C inquires about daily routines and mealtime rules, which often reflect cultural practices and values. Question D relates to the parents' beliefs about disability, which can be shaped by cultural, religious, or societal perspectives. Therefore, these questions are more likely to provide information about the family's cultural values compared to the child's date of birth.

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