Nursing Elites

1. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?

• A. Insulin
• B. Steroids
• C. Antibiotics
• D. Anticonvulsants

Correct answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A), antibiotics (Choice C), and anticonvulsants (Choice D) do not interact with the varicella vaccine in the same way as steroids, and therefore, they are not contraindicated.

2. The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?

• A. Risk for impaired skin integrity due to the cast and its location.
• B. Deficient knowledge related to cast care.
• C. Risk for delayed development related to immobility.
• D. Self-care deficit related to immobility.

Correct answer: A

Rationale: The correct answer is A: Risk for impaired skin integrity due to the cast and its location. When a child has a long-leg hip spica cast, the priority nursing diagnosis is to prevent impaired skin integrity. This is because the child's mobility is restricted, and pressure from the cast can lead to skin breakdown. Option B is incorrect as while education is essential, it is not the priority when skin integrity is at risk. Option C is incorrect because while immobility can impact development, immediate skin integrity concerns take precedence. Option D is incorrect as self-care deficit, while important, is secondary to preventing skin breakdown in this scenario.

3. What is the first action a healthcare provider should take before administering a tube feeding to an infant?

• A. Irrigate the tube with water.
• B. Offer a pacifier to the infant.
• C. Slowly instill 10 mL of formula.
• D. Place the infant in the Trendelenburg position.

Correct answer: B

Rationale: The correct answer is to offer a pacifier to the infant before administering tube feeding. Offering a pacifier helps stimulate the sucking reflex, preparing the infant for feeding and promoting digestion and comfort. Irrigating the tube with water (Choice A) is not typically the first action before tube feeding and may not be necessary. Slowly instilling formula (Choice C) should only be done after the infant is prepared for feeding. Placing the infant in the Trendelenburg position (Choice D) is not necessary and may not be recommended for tube feeding.

4. A parent calls the clinic because their child has ingested a small amount of household bleach. What should the nurse advise?

• A. Administer activated charcoal
• B. Induce vomiting immediately
• C. Call the poison control center
• D. Take the child to the emergency department

Correct answer: C

Rationale: In the case of a child ingesting household bleach, the primary advice should be to call the poison control center (Choice C). The poison control center can provide specific guidance on how to manage the ingestion, including whether any immediate interventions are necessary. Administering activated charcoal (Choice A) or inducing vomiting immediately (Choice B) can worsen the situation as they are not recommended treatments for bleach ingestion. Taking the child to the emergency department (Choice D) may be necessary depending on the advice given by the poison control center, but the initial step should be to seek guidance from the experts at the poison control center.

5. When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, what does this decision indicate?

• A. The newborn has no rights.
• B. It is the same as euthanasia.
• C. It is illegal professional practice.
• D. The newborn is being allowed to die.

Correct answer: D

Rationale: When a family decides to withhold 'extraordinary care' for a newborn with severe abnormalities, it means that aggressive interventions will not be pursued, allowing the newborn to die naturally. This decision is legal and ethical, respecting the principle of non-maleficence by avoiding unnecessary suffering. Choice A is incorrect because all individuals, including newborns, have rights, but the decision to withhold extraordinary care is based on ethical considerations. Choice B is incorrect as withholding care is not the same as euthanasia, which involves actively ending life. Choice C is incorrect as long as the decision is made within legal and ethical boundaries, it is not considered illegal professional practice.

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