Nursing Elites

1. A nurse is teaching the parents of a toddler about the signs and symptoms of lead poisoning. Which symptom should the nurse emphasize?

• A. Abdominal pain
• B. Constipation
• C. Irritability
• D. Frequent urination

Correct answer: C

Rationale: Irritability is a significant symptom of lead poisoning in toddlers and should be emphasized to parents. Lead poisoning can manifest with various symptoms, but irritability is particularly common in children exposed to lead. Abdominal pain (Choice A) is not a typical symptom of lead poisoning in toddlers. While constipation (Choice B) can occur, it is less specific and less common than irritability. Frequent urination (Choice D) is not a typical symptom associated with lead poisoning in toddlers and is less relevant for parents to recognize in this context.

2. A child has undergone a tonsillectomy, and a nurse is providing postoperative care. What is an important nursing intervention?

• A. Encouraging deep breathing exercises
• B. Encouraging the child to eat
• C. Administering antibiotics
• D. Applying ice to the throat

Correct answer: C

Rationale: Administering antibiotics is a crucial nursing intervention after a tonsillectomy because it helps prevent infections, which are a common postoperative complication. Encouraging deep breathing exercises (Choice A) is also important for promoting lung expansion and preventing respiratory complications. Encouraging the child to eat (Choice B) may not be appropriate immediately after a tonsillectomy due to the risk of throat irritation and discomfort. Applying ice to the throat (Choice D) is generally not recommended post-tonsillectomy as it may cause vasoconstriction and hinder the healing process.

3. A child with a diagnosis of gastroenteritis is admitted to the hospital. What is the priority nursing intervention?

• A. Monitoring fluid and electrolyte balance
• B. Encouraging regular exercise
• C. Administering antipyretics
• D. Administering antibiotics

Correct answer: A

Rationale: The correct answer is monitoring fluid and electrolyte balance. Gastroenteritis is characterized by inflammation of the gastrointestinal tract, leading to fluid loss. Maintaining fluid and electrolyte balance is essential in managing gastroenteritis to prevent dehydration and electrolyte imbalances. Encouraging regular exercise (Choice B) is not a priority in the acute phase of gastroenteritis when the focus is on rehydration and symptom management. Administering antipyretics (Choice C) may be considered for fever management but is not the priority over monitoring fluid and electrolyte balance. Administering antibiotics (Choice D) is not routinely indicated for viral gastroenteritis, which is a common cause of the condition in children.

4. An 18-month-old was brought to the emergency department by her mother, who states, 'I think she broke her arm.' The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal?

• A. Plastic deformity
• B. Buckle fracture
• C. Spiral fracture
• D. Greenstick fracture

Correct answer: C

Rationale: A spiral fracture is a type of fracture often associated with twisting injuries and can raise suspicion of child abuse. This type of fracture is caused by a twisting force applied to a bone. Plastic deformity is not typically associated with fractures but refers to the ability of a material to change shape and retain that shape. A buckle fracture, also known as a torus fracture, is an incomplete break in a bone commonly seen in children. A greenstick fracture is an incomplete fracture where the bone is bent and partially broken, more commonly seen in children due to their bone flexibility.

5. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

• A. abdominal rigidity and pain on palpation
• B. rounded abdomen and hypoactive bowel sounds
• C. visible peristalsis and weight loss
• D. distention of the lower abdomen and constipation

Correct answer: C

Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. The obstruction at the pyloric sphincter causes visible peristalsis as the stomach tries to push food through the narrowed opening, leading to the appearance of waves across the abdomen. Weight loss occurs due to poor feeding and frequent vomiting associated with pyloric stenosis. Choices A, B, and D are incorrect. Abdominal rigidity and pain on palpation, rounded abdomen and hypoactive bowel sounds, as well as distention of the lower abdomen and constipation are not typically seen in pyloric stenosis.

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