Nursing Elites

1. Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess?

• A. Mild cough
• B. Slight fever
• C. Chest pain
• D. Bulging fontanel

Correct answer: C

Rationale: Chest pain is a common symptom seen in patients with pneumococcal pneumonia. It can result from inflammation of the pleura or irritation of the diaphragm due to the infection. While cough and fever are also common symptoms, chest pain is particularly significant in pneumonia cases as it can be a distressing symptom for the patient and may indicate complications or severity of the infection. Bulging fontanel, on the other hand, is more indicative of conditions affecting infants and is not typically associated with pneumococcal pneumonia in a 12-year-old boy.

2. What is the term for a condition where there is a failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children, with 80% of cases being idiopathic? It may present with familial patterns, affecting males more than females.

• A. Cretinism
• B. Growth hormone deficiency
• C. Hypothyroidism
• D. Precocious puberty

Correct answer: B

Rationale: Growth hormone deficiency refers to a condition where there is inadequate production of growth hormone by the pituitary gland. This results in impaired growth in children. While 80% of cases are of unknown cause (idiopathic), some may have familial patterns. It is more common in males than females. Cretinism is a condition of severe hypothyroidism during infancy, not related to growth hormone. Hypothyroidism is a disorder involving low thyroid hormone levels, and precocious puberty is the early onset of puberty. Therefore, the correct answer is 'Growth hormone deficiency.'

3. An 18-month-old child presents with fever, nasal flaring, intercostal retractions, and a respiratory rate of 50 bpm. What is the most appropriate nursing diagnosis?

• A. High risk for altered body temperature - hyperthermia
• B. Ineffective breathing pattern
• C. Ineffective individual coping
• D. Knowledge deficit

Correct answer: B

Rationale: In this case, the child is showing signs of respiratory distress, such as nasal flaring, intercostal retractions, and an increased respiratory rate. These are indicative of an ineffective breathing pattern. The child's compromised respiratory function requires immediate attention and intervention, making 'Ineffective breathing pattern' the most appropriate nursing diagnosis. Choices A, C, and D do not address the respiratory distress the child is experiencing and are not the priority in this situation.

4. A breastfeeding mother complains of sore nipples. Which intervention should the nurse suggest?

• A. Use a breast pump until nipples heal
• B. Apply lanolin cream after each feeding
• C. Wash nipples with soap and water before and after each feeding
• D. Reduce the frequency of breastfeeding

Correct answer: B

Rationale: The correct intervention for sore nipples in a breastfeeding mother is to suggest applying lanolin cream after each feeding. Lanolin cream can help soothe and protect the nipples, promoting healing and reducing discomfort. Using a breast pump may not address the underlying issue causing soreness. Washing nipples with soap and water excessively can lead to dryness and further irritation. Reducing breastfeeding frequency may impact milk supply and bonding. Therefore, recommending lanolin cream is the most appropriate intervention to alleviate soreness in this situation.

5. Which of the following are not infectious causes of diarrhea?

• A. Allergy
• B. Bacteria
• C. Parasite
• D. Virus

Correct answer: A

Rationale: Diarrhea can be caused by various infectious agents such as bacteria, parasites, and viruses. Allergy, on the other hand, is a non-infectious cause of diarrhea. When an individual with a food allergy consumes the specific food they are allergic to, it can trigger diarrhea as a part of the allergic reaction.

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