Nursing Elites

1. A school nurse is teaching parents of school-age children about the importance of immunizations for childhood communicable diseases. What preventable disease may cause the complication of encephalitis?

• A. Varicella
• B. Scarlet fever
• C. Poliomyelitis
• D. Whooping cough

Correct answer: A

Rationale: The correct answer is Varicella (chickenpox), choice A. Varicella can lead to the complication of encephalitis, which is the inflammation of the brain. Scarlet fever (choice B) is caused by Group A Streptococcus bacteria and does not typically lead to encephalitis. Poliomyelitis (choice C) is a viral infection that affects the nervous system but does not directly cause encephalitis. Whooping cough (choice D), also known as pertussis, primarily affects the respiratory system and does not commonly result in encephalitis.

2. What is the typical therapeutic management treatment for children with Hirschsprung disease?

• A. Daily enemas
• B. Low-fiber diet
• C. Permanent colostomy
• D. Surgical removal of affected section of bowel

Correct answer: D

Rationale: The most common treatment for Hirschsprung disease is the surgical removal of the affected section of the bowel. This procedure entails excising the part of the colon that lacks nerve cells crucial for normal bowel function. Daily enemas (Choice A) can offer temporary relief for constipation but do not address the root cause of the condition, which is the absence of nerve cells. A low-fiber diet (Choice B) is not a primary therapy for Hirschsprung disease and may not effectively manage the disorder. A permanent colostomy (Choice C) is typically considered in severe cases where other interventions have failed and is not the standard management approach for Hirschsprung disease.

3. At 7 AM, a nurse receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?

• A. Encourage the adolescent to start exercising.
• B. Ask the adolescent to obtain an immediate glucometer reading.
• C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
• D. Tell the adolescent that the prescribed dose of rapid acting insulin should be administered.

Correct answer: D

Rationale: Rapid acting insulin will help lower the elevated blood glucose level quickly.

4. What clinical manifestation of tetralogy of Fallot should the nurse expect when caring for children with this diagnosis?

• A. Slow respirations
• B. Clubbing of fingers
• C. Decreased RBC counts
• D. Subcutaneous hemorrhages

Correct answer: B

Rationale: Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. Clubbing occurs as a result of long-standing decreased oxygen levels in the blood, leading to changes in the fingertips. Slow respirations (Choice A) are not typically a direct clinical manifestation of tetralogy of Fallot. While decreased RBC counts (Choice C) may occur due to chronic hypoxia, they are not a primary manifestation specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a common clinical manifestation associated with tetralogy of Fallot.

5. What is the priority intervention for a child with acute laryngotracheobronchitis upon admission?

• A. Pad the side rails of the crib.
• B. Arrange for a quiet, cool room.
• C. Place a tracheotomy set at the bedside.
• D. Obtain a recliner for a parent to stay.

Correct answer: C

Rationale: The correct priority intervention for a child with acute laryngotracheobronchitis is to place a tracheotomy set at the bedside. Acute laryngotracheobronchitis can lead to airway obstruction, making it essential to have the equipment readily available in case of emergency. Padding the side rails, arranging for a quiet room, or obtaining a recliner for a parent are not the immediate priorities in managing a child with this condition.

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