Nursing Elites

1. A parent asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent about rubeola that is different from rubella?

• A. High fever and Koplik spots
• B. Rash on the trunk with pruritus
• C. Nausea, vomiting, and abdominal cramps
• D. Characteristics of a cold, followed by a rash

Correct answer: A

Rationale: The correct answer is A: 'High fever and Koplik spots.' Rubeola (measles) is characterized by a high fever and the presence of Koplik spots, which are not seen in rubella (German measles). Choice B, rash on the trunk with pruritus, is more indicative of rubella. Choice C, nausea, vomiting, and abdominal cramps, are not specific to either rubeola or rubella. Choice D, characteristics of a cold followed by a rash, is not a typical presentation of rubeola or rubella.

2. A 7-year-old child with a history of seizures is being discharged from the hospital. What should the nurse include in the discharge teaching for the parents?

• A. Administer antiepileptic medication as prescribed, not just when a seizure occurs
• B. Ensure the child gets adequate sleep
• C. Restrict the child's activities to prevent seizures
• D. Teach seizure first aid to family members

Correct answer: D

Rationale: The correct answer is to teach seizure first aid to family members. This is crucial because family members need to know how to appropriately respond during a seizure to ensure the child's safety. Choice A has been corrected to emphasize that antiepileptic medication should be administered as prescribed, not just when a seizure occurs, to effectively manage the condition. Choice B, while important for overall health, is not directly related to seizure management. Choice C is not recommended as restricting activities may not prevent seizures and may hinder the child's quality of life.

3. When assessing a child with suspected bacterial meningitis, what clinical manifestation is the nurse likely to observe?

• A. Photophobia
• B. High fever
• C. Rash
• D. Nasal congestion

Correct answer: B

Rationale: The correct answer is B: High fever. In bacterial meningitis, a high fever is a common clinical manifestation due to the body's inflammatory response to the infection. While photophobia (choice A) is also a common symptom in meningitis, it is not as specific as a high fever. Rash (choice C) is more commonly associated with viral infections or other conditions, rather than bacterial meningitis. Nasal congestion (choice D) is not a typical clinical manifestation of bacterial meningitis and is more commonly seen in respiratory infections. Therefore, when assessing a child with suspected bacterial meningitis, the nurse is most likely to observe a high fever as a key clinical manifestation.

4. What should be included in the nursing plan of care for a 6-month-old infant admitted to the pediatric unit with a diagnosis of respiratory syncytial virus (RSV)?

• A. Place the infant in a warm, dry environment.
• B. Allow parents and siblings to visit.
• C. Maintain standard and contact precautions.
• D. Administer prescribed antibiotics immediately.

Correct answer: C

Rationale: The correct answer is C: Maintain standard and contact precautions. RSV is highly contagious, primarily spread through respiratory secretions. Therefore, it is crucial to implement infection control measures such as standard and contact precautions to prevent the spread of the virus to other patients, staff, and visitors. Choice A is incorrect because warmth and dryness are not specific interventions for RSV; the focus should be on infection control. Choice B may increase the risk of exposing others to RSV, so limiting visitors is recommended. Choice D is unnecessary because RSV is a viral infection, and antibiotics are not effective against viruses.

5. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?

• A. Mental retardation
• B. Inherited genetic factors
• C. Delayed physical growth
• D. Clubbing of the fingertips

Correct answer: C

Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.

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