Nursing Elites

1. What should the nurse suggest to a parent asking for help with a child experiencing night terrors?

• A. Encourage the child to talk about the night terrors.
• B. Establish a bedtime routine.
• C. Allow the child to sleep with the parents.
• D. Wake the child during the night.

Correct answer: B

Rationale: Establishing a bedtime routine is the most appropriate suggestion for a parent seeking help with a child experiencing night terrors. Bedtime routines can create a sense of security and predictability for the child, potentially reducing the frequency of night terrors. Encouraging the child to talk about the night terrors (Choice A) may not be effective during the episode as the child is usually not fully awake. Allowing the child to sleep with the parents (Choice C) may inadvertently reinforce the behavior and hinder the child’s ability to learn to self-soothe. Waking the child during the night (Choice D) may disrupt the sleep cycle and exacerbate the night terrors.

2. A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?

• A. Suction the oropharynx
• B. Insert a nasopharyngeal airway
• C. Initiate positive pressure ventilations
• D. Administer oxygen via mask

Correct answer: A

Rationale: In this scenario, the patient is experiencing airway compromise due to the fall and potential oropharyngeal obstruction from bleeding. Performing a jaw-thrust maneuver with head stabilization helps maintain the airway patency. The next step should be to suction the oropharynx to clear any blood or secretions, which can obstruct the airway and lead to aspiration. Inserting a nasopharyngeal airway may worsen bleeding or cause further injury to the patient's airway. Initiating positive pressure ventilations can be ineffective if the airway is not cleared first. Administering oxygen via mask is not the immediate priority; ensuring a patent airway by suctioning takes precedence.

3. A nurse is planning an evening snack for a child receiving Novolin N insulin. What is the reason for this nursing action?

• A. To encourage the child to stay on the diet.
• B. Energy is needed for immediate utilization.
• C. Extra calories will help the child gain weight.
• D. Nourishment helps to counteract late insulin activity.

Correct answer: D

Rationale: The correct answer is D. Novolin N insulin peaks in the evening, leading to a higher risk of hypoglycemia during this time. Providing a snack before bedtime helps counteract the late insulin activity and prevent hypoglycemia. Choice A is incorrect as the primary reason for the snack is related to insulin activity rather than diet compliance. Choice B is not directly related to the timing of Novolin N insulin administration. Choice C is unrelated to the specific need for a snack in the evening to address insulin activity.

4. A 2-year-old child with a diagnosis of autism spectrum disorder is being discharged. What should the nurse include in the discharge teaching?

• A. Maintain a structured routine
• B. Encourage social interaction
• C. Use positive reinforcement
• D. Use a communication board

Correct answer: A

Rationale: The correct answer is to maintain a structured routine. Children with autism spectrum disorder benefit greatly from structured routines as they provide a sense of stability and predictability, which can help reduce anxiety and improve behavior. Encouraging social interaction (Choice B) is important but may need to be approached in a structured manner to prevent overwhelming the child. Positive reinforcement (Choice C) is also beneficial for behavior management but may not address the overall need for routine and predictability that is crucial for children with autism. Using a communication board (Choice D) may be helpful for facilitating communication, but establishing and maintaining a structured routine is fundamental for supporting the child's development and well-being in managing their autism spectrum disorder.

5. A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?

• A. Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide.
• B. The drug prevents your baby from requiring excessive sedation.
• C. Surfactant is used to reduce episodes of periodic apnea.
• D. Your baby needs this medication to combat a potential respiratory tract infection.

Correct answer: A

Rationale: The correct answer is A. Surfactant therapy is explained to parents as a treatment that enhances the lungs' ability to exchange oxygen and carbon dioxide. This is essential for premature infants with respiratory distress syndrome (RDS) as it helps improve their respiratory function. Choices B, C, and D are incorrect because surfactant therapy primarily focuses on addressing lung function and is not related to sedation, apnea reduction, or fighting respiratory tract infections.

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