Nursing Elites

1. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

2. A teenager is accompanied by his mother to the annual physical examination. The nurse is aware of privacy issues related to the teenager. While the mother is in the room, which topic should the nurse avoid?

• A. School performance
• B. Seatbelt use
• C. Cigarette smoking
• D. School friends

Correct answer: C

Rationale: The correct answer is C: Cigarette smoking. Discussing sensitive topics like cigarette smoking in the presence of a parent may inhibit the teenager's willingness to be open and honest. It's important to provide an opportunity for the teenager to speak privately with the healthcare provider. Choices A, B, and D are more general topics that can be discussed openly in front of the parent without compromising the teenager's privacy or comfort.

3. If the needs of the infant are met in a loving, consistent manner, the infant will develop a sense of:

• A. Trust
• B. Love
• C. Independence
• D. Responsibility

Correct answer: A

Rationale: The correct answer is A: Trust. According to Erikson's psychosocial development theory, when infants receive consistent and loving care, they develop trust. This trust forms the basis of the first stage of psychosocial development, known as Trust vs. Mistrust. Trust is essential for healthy social and emotional development. Choice B, Love, is incorrect as it is more of an emotion than a developmental stage. Choice C, Independence, typically occurs later in development during Erikson's Autonomy vs. Shame and Doubt stage. Choice D, Responsibility, is also not the correct answer as it relates more to later stages of development where individuals develop a sense of duty and obligation.

4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

• A. Focus communication on the child.
• B. Use easy analogies when possible.
• C. Explain experiences of others to the child
• D. Assure the child that communication is private

Correct answer: A

Rationale: Focusing communication directly on the child aligns with their egocentric nature and helps engage them in the conversation.

5. Using knowledge of child development, what approach is best when preparing a toddler for a procedure?

• A. Avoid asking the child to make choices.
• B. Plan for a teaching session to last about 20 minutes.
• C. Demonstrate on a doll how the procedure will be done.
• D. Show the necessary equipment without allowing child to handle it.

Correct answer: C

Rationale: Demonstrating on a doll helps the toddler understand what will happen in a non-threatening way, making the procedure less intimidating. Long teaching sessions or avoiding choices can increase anxiety.

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