Nursing Elites

1. An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention?

• A. Keep buttons, beads, and other small objects out of his reach.
• B. Do not permit him to chew paint from window ledges because he might absorb too much lead.
• C. When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall.
• D. Lock the crib sides securely because he may stand and lean against them and fall out of bed.

Correct answer: A

Rationale: Small objects are a choking hazard for infants, so it is crucial to keep them out of reach to prevent injury.

2. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?

• A. The parent is trying to feed the child only what the child likes most
• B. Hispanics believe the evil eye enters when a person gets cold
• C. The parent is trying to restore normal balance through appropriate hot remedies
• D. Hispanics believe an innate energy called chi is strengthened by eating soup

Correct answer: C

Rationale: In Hispanic culture, the balance between hot and cold is important, and the parent may be giving the child broth to restore this balance while avoiding "cold" foods.

3. The nurse is teaching parents about diarrhea in young children. A parent asks the nurse what causes most cases of diarrhea in young children. How should the nurse respond?

• A. Rotavirus
• B. Giardia
• C. Shigella
• D. Salmonella

Correct answer: A

Rationale: Rotavirus is the most common cause of diarrhea in young children, particularly those under the age of 2. Giardia, Shigella, and Salmonella can also cause diarrhea, but in the context of young children, Rotavirus is the primary pathogen responsible for diarrheal illnesses.

4. For a child with Kawasaki disease, which symptom is most indicative of the acute phase?

• A. Strawberry tongue
• B. Joint pain
• C. Rash
• D. Peeling skin

Correct answer: A

Rationale: The correct answer is A: Strawberry tongue. In Kawasaki disease, a 'strawberry tongue' is most indicative of the acute phase. This refers to the tongue appearing red and swollen with enlarged fungiform papillae, giving it a strawberry-like appearance. Joint pain (Choice B) is more commonly associated with other conditions like rheumatoid arthritis. Rash (Choice C) and peeling skin (Choice D) are also seen in Kawasaki disease but are not as specific to the acute phase as the presence of a strawberry tongue.

5. Nurses should be alert for increased fluid requirements in which circumstance?

• A. Fever
• B. Mechanical ventilation
• C. Congestive heart failure
• D. Increased intracranial pressure

Correct answer: A

Rationale: Fever increases metabolic rate, leading to insensible water loss, thus requiring increased fluid intake. Mechanical ventilation, CHF, and increased intracranial pressure generally require fluid restriction rather than increased fluid intake.

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