Nursing Elites

1. A caregiver is seeking guidance from a healthcare provider concerning a child diagnosed with impetigo. Which of the following instructions should the healthcare provider include?

• A. Apply warm compresses to the affected area.
• B. Keep the child home from school until lesions are crusted over.
• C. Apply antibiotic ointment to the lesions.
• D. Cleanse the affected area with hydrogen peroxide.

Correct answer: C

Rationale: The healthcare provider should recommend applying antibiotic ointment to the lesions to prevent the spread of infection and facilitate healing. Antibiotic ointment helps combat the bacterial infection associated with impetigo and supports the skin's recovery process. This approach aids in reducing symptoms, preventing complications, and promoting a quicker resolution of the condition.

2. A child receives a vaccine for MMR. Six hours after the injection, the child’s parent reports local soreness, erythema, lethargy, and a fever of 101°F to a nurse. Which action should the nurse take?

• A. Give instructions on relieving symptoms with acetaminophen
• B. Seek emergency help, because these symptoms are signs of anaphylactic reaction
• C. Tell the parent that a live vaccine will cause a mild case of measles
• D. Obtain and fill out a Vaccine Adverse Event Report form

Correct answer: A

Rationale: Low-grade fever, malaise, and muscle aches are common reactions. Acetaminophen usually alleviates these problems. MMR is a live vaccine but it is attenuated or completely avirulent and does not cause measles in healthy children, only immunocompromised children.

3. When receiving change-of-shift report for children, which child should the nurse assess first?

• A. A toddler who has a concussion and an episode of forceful vomiting
• B. An adolescent with infective endocarditis who reports having a headache
• C. An adolescent who was placed into Halo traction 1 hour ago and rates his pain at a 6 on a 0-10 scale
• D. A school-age child with acute glomerulonephritis and brown-colored urine

Correct answer: A

Rationale: The nurse should assess the toddler with a concussion and an episode of forceful vomiting first when receiving change-of-shift report for children. Forceful vomiting in a toddler with a concussion indicates increased intracranial pressure, requiring immediate assessment and intervention to prevent further complications.

4. A caregiver is providing teaching about car seat use to the mother of a six-month-old infant. Which of the following statements by the mother indicates an understanding of the teaching?

• A. I should secure the car seat using lower anchors and tethers instead of the seat belt
• B. I should position the car seat harness one inch above my baby's shoulders
• C. I will make sure that the car seat is placed at a 90-degree angle
• D. I will pad my baby's car seat with a blanket for traveling long distances

Correct answer: A

Rationale: The correct answer is A. Lower anchors and tethers, known as the LATCH child safety seat system, should be used to secure an infant's car seat in the vehicle. This system provides a safer and more secure way of installing the car seat compared to using the seat belt alone. Using the lower anchors and tethers ensures proper installation and reduces the risk of car seat movement during travel, providing optimal protection for the infant. Choices B, C, and D are incorrect. Choice B is incorrect because the car seat harness should be positioned at or below the baby's shoulders, not above. Choice C is incorrect because the car seat should be positioned at the correct recline angle recommended by the car seat manufacturer, which may not necessarily be 90 degrees. Choice D is incorrect because adding padding like a blanket to the car seat is not recommended as it can interfere with the proper fit and function of the car seat, potentially compromising the safety of the infant.

5. Which statement regarding the human papillomavirus vaccine (Gardasil) is true?

• A. Gardasil is administered in a two-dose series.
• B. Gardasil provides protection against chlamydia.
• C. Gardasil is recommended for males and females.
• D. Gardasil becomes effective after the first dose.

Correct answer: C

Rationale: Gardasil is recommended for both males and females to protect against HPV and related conditions such as genital warts and certain cancers. It is essential for both genders to receive the vaccine to prevent the spread of HPV and its associated health risks.

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