Nursing Elites

1. 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.

2. A child has been diagnosed with classic hemophilia. A nurse teaches the child’s parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?

• A. Whenever a bleed is suspected
• B. In the morning on scheduled days
• C. At bedtime while the child is lying quietly in bed
• D. On a regular schedule at the parents’ convenience

Correct answer: B

Rationale: Administering factor VIII in the morning on scheduled days ensures that there is a consistent level of the plasma component throughout the day, especially when the child is active. This timing helps to maintain adequate levels of factor VIII to prevent bleeding episodes. Choice A is incorrect because administering factor VIII only when a bleed is suspected would not provide the consistent prophylactic coverage needed for children with hemophilia. Choice C is incorrect as bedtime administration may not be practical for ensuring the plasma component is available during the child's active hours. Choice D is incorrect because administering factor VIII on a regular schedule, rather than at specific times of the day, may not optimize its effectiveness in preventing bleeding episodes.

3. When obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism, what would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: In congenital hypothyroidism, infants often experience lethargy and difficulty staying awake due to low thyroid hormone levels. Choice A is incorrect as hypothyroidism can lead to poor growth in infants. Choice B is incorrect because hypothyroidism can cause decreased activity levels and lethargy rather than being active and playful. Choice C is incorrect as hypothyroidism can result in dry skin and poor skin tone, not necessarily pink and healthy-looking skin.

4. A parent of an 11-month-old infant who has a cleft palate asks the nurse why it was recommended that closure of the palate should be done before the age of 2. How should the nurse respond?

• A. “After age 2, surgery is frightening and should be avoided if possible.”
• B. “Eruption of the 2-year molars often complicates the surgical procedure.”
• C. “As your child gets older, the palate gets wider and more difficult to repair.”
• D. “Surgery should be performed before your child starts to use faulty speech patterns.”

Correct answer: D

Rationale: Closure of the cleft palate is recommended before the age of 2 to prevent the development of faulty speech patterns. Performing surgery at a younger age helps avoid speech difficulties that may arise if the repair is delayed. Choice A is incorrect as it focuses on fear, not the developmental aspect. Choice B is incorrect as the eruption of molars is not the primary reason for early surgery. Choice C is incorrect because the difficulty of repair is not solely related to the width of the palate but also to speech development.

5. A child is being assessed for suspected appendicitis. What clinical manifestation is the healthcare professional likely to observe?

• A. Right lower quadrant pain
• B. Left lower quadrant pain
• C. Rebound tenderness
• D. Epigastric pain

Correct answer: A

Rationale: Right lower quadrant pain is a classic symptom of appendicitis. The appendix is typically located in the right lower quadrant of the abdomen, so pain in this area is commonly associated with appendicitis. Choices B, C, and D are incorrect because left lower quadrant pain, rebound tenderness, and epigastric pain are not typical manifestations of appendicitis. Left lower quadrant pain is not associated with appendicitis since the appendix is situated in the right lower quadrant. Rebound tenderness is more commonly linked with peritonitis rather than appendicitis. Epigastric pain is not a typical presentation of appendicitis as the pain is usually localized to the right lower quadrant.

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