Nursing Elites

1. During a vaccination drive at a well-child clinic, a nurse observes that a recently hired nurse is not wearing gloves. What should the nurse advise the newly hired nurse to do?

• A. Speak with the nurse manager regarding techniques.
• B. Put on gloves because standard precautions are required.
• C. Continue with the immunizations because gloves are not needed.
• D. Evaluate the child’s appearance to determine whether gloves are needed.

Correct answer: B

Rationale: The correct answer is B: "Put on gloves because standard precautions are required." Standard precautions are essential in healthcare settings to prevent the transmission of infections, and wearing gloves is a crucial part of these precautions during immunizations. Choice A is incorrect because speaking with the nurse manager about techniques does not address the immediate need for wearing gloves. Choice C is incorrect because gloves are indeed needed to prevent the spread of infections. Choice D is incorrect as evaluating the child's appearance is not a substitute for wearing gloves which are a basic infection control measure.

2. A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?

• A. Cannot stand on one foot
• B. Builds a tower of 7 blocks
• C. Uses echolalia when speaking
• D. Colors outside the lines of a picture

Correct answer: C

Rationale: The correct answer is C. Using echolalia, which is the repetition of words or phrases, is not typical for a 2-year-old child and may indicate the need for further evaluation. Choices A, B, and D are all within the expected developmental skills for a 2-year-old. While most 2-year-olds may not be able to stand on one foot, it is not a cause for concern at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both appropriate for a 2-year-old's developmental skills.

3. The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?

• A. Shortened prothrombin time
• B. Increased fibrinogen level
• C. Positive fibrin split products
• D. Increased platelets

Correct answer: C

Rationale: Positive fibrin split products indicate disseminated intravascular coagulation (DIC), a condition characterized by the widespread formation of blood clots throughout the body. In DIC, clotting factors are consumed, leading to increased fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster blood clotting, which is not consistent with the pathophysiology of DIC. An increased fibrinogen level (Choice B) is also not a characteristic finding in DIC, as fibrinogen levels may be decreased due to consumption in the formation of clots. Increased platelets (Choice D) are not typically observed in DIC; instead, thrombocytopenia (decreased platelet count) is more common due to their consumption in clot formation.

4. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?

• A. Monitor for signs of infection
• B. Monitor blood pressure
• C. Monitor for hyperglycemia
• D. Monitor for hypertension

Correct answer: A

Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention, reducing the risk of complications. While monitoring blood pressure (choice B) is important in nephrotic syndrome, it is not the most immediate concern when the child is on corticosteroids. Monitoring for hyperglycemia (choice C) is relevant in corticosteroid therapy, but the priority in this scenario is to watch for signs of infection. Monitoring for hypertension (choice D) is important in nephrotic syndrome but is not the most critical consideration when the child is on corticosteroids.

5. A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?

• A. Feeding problems are common in neonates.
• B. Inadequate sucking is not significant in the absence of cyanosis.
• C. Ineffective sucking and swallowing may be early indications of a heart defect.
• D. Many neonates retain mucus, which may interfere with feeding for several weeks.

Correct answer: C

Rationale: In this scenario, the nurse should consider that ineffective sucking and swallowing in a 2-week-old infant could be early signs of a heart defect such as a ventricular septal defect. This is crucial information as it can guide further assessment and management. Choice A is incorrect because while feeding problems can be common in neonates, in this case, the specific context of a suspected heart defect should be prioritized. Choice B is incorrect as inadequate sucking can indeed be significant, especially when considering potential underlying heart issues, regardless of the presence of cyanosis. Choice D is incorrect as while mucus retention can affect feeding, in this case, the focus should be on the possibility of a heart defect rather than a temporary issue like mucus interference.

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