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 child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?

• A. Monitor blood glucose levels once a day
• B. Follow a strict meal plan
• C. Administer insulin only when blood glucose is high
• D. Recognize signs of hypoglycemia

Correct answer: D

Rationale: Recognizing signs of hypoglycemia is crucial for managing type 1 diabetes mellitus and preventing complications.

3. A child with a diagnosis of sickle cell anemia is experiencing a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: Administering pain medication is the most crucial nursing intervention during a vaso-occlusive crisis in sickle cell anemia. Pain management is a priority to alleviate the patient's discomfort and improve outcomes. Administering oxygen may be necessary in some cases but is not the primary intervention for vaso-occlusive crisis. Monitoring fluid intake is important in sickle cell anemia but is not the priority during a crisis situation. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can exacerbate pain and complications.

4. How should you care for an alert 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color?

• A. Back blows, abdominal thrusts, transport
• B. Oxygen, avoiding agitation, transport
• C. Assisting ventilations, back blows, transport
• D. Chest thrusts, finger sweeps, transport

Correct answer: B

Rationale: The correct approach for an alert 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color is to provide oxygen, avoid agitation, and arrange for transport. Oxygen helps support breathing, avoiding agitation prevents worsening of the obstruction, and transport ensures the child receives further medical evaluation and treatment. Choices A, C, and D involve techniques that are not recommended for a mild airway obstruction in this scenario. Back blows, abdominal thrusts, chest thrusts, and finger sweeps are interventions used for different situations and not suitable for a child with the described symptoms.

5. During a nap, a 3-year-old hospitalized child wets the bed. How should the nurse respond?

• A. Ask the child to help with remaking the bed.
• B. Put clean sheets on the bed over a rubber sheet.
• C. Change the child’s clothes without discussing the incident.
• D. Explain that children should call the nurse when they need to go to the bathroom.

Correct answer: C

Rationale: When a 3-year-old hospitalized child wets the bed during a nap, the nurse should respond by changing the child’s clothes without discussing the incident. This approach helps to maintain the child's dignity, avoid embarrassment, and reduce anxiety related to bedwetting. Asking the child to help with remaking the bed (Choice A) may not be appropriate as it could cause unnecessary distress. Putting clean sheets on the bed over a rubber sheet (Choice B) addresses the aftermath but does not directly address the child's needs. Explaining that children should call the nurse when they need to go to the bathroom (Choice D) may not be effective in this immediate situation of bedwetting during a nap.

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