Nursing Elites

1. When teaching parents of a school-aged child with a new diagnosis of osteomyelitis of the tibia, which statement by the parents indicates an understanding of the teaching?

• A. My child will have a cast until healing is complete.
• B. My child will receive antibiotics for several weeks.
• C. My child can return to playing sports once he is discharged.
• D. My child needs to be in contact isolation.

Correct answer: B

Rationale: The correct answer is B. Osteomyelitis of the tibia typically requires antibiotic therapy for at least 4 weeks. Surgery may be necessary if the infection does not respond to antibiotics. Weight-bearing should be avoided with osteomyelitis to prevent complications. Choices A, C, and D are incorrect because a cast until healing, returning to sports immediately, and contact isolation are not primary management strategies for osteomyelitis.

2. When conducting an initial feeding evaluation, the therapist asks the caregiver to bring the utensils, food, and high chair that they typically use. Which statement best reflects the therapist's reasoning for this?

• A. Using the child's actual materials will give the therapist an accurate picture
• B. The therapist wants to be sensitive to the child's culture
• C. The center has limited funds for food and materials
• D. The therapist would like to know if the caregiver can follow directions

Correct answer: A

Rationale: By having the caregiver bring the child's familiar utensils, food, and high chair, the therapist can observe the child's typical eating behaviors and challenges accurately. This provides valuable insights that help in tailoring appropriate interventions to address feeding issues effectively.

3. In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?

• A. The child with tachypnea and pulmonary congestion
• B. The child with hepatomegaly and normal respiratory rate
• C. The child with dependent and sacral edema and regular pulse
• D. The child with periorbital edema and normal respiratory rate

Correct answer: A

Rationale: The child with tachypnea and pulmonary congestion should be seen first. Tachypnea indicates an increased respiratory rate, a sign of possible respiratory distress. Pulmonary congestion suggests fluid accumulation in the lungs, posing a serious risk to respiratory function. Immediate attention is crucial in this case. Choice B is incorrect as hepatomegaly alone does not indicate an acute issue requiring immediate attention. Choices C and D, while showing signs of fluid-volume excess, do not present the same level of respiratory compromise as tachypnea and pulmonary congestion, making them lower priority.

4. The healthcare provider is planning care for a patient receiving morphine sulfate via a patient-controlled analgesia pump. Which intervention may be required due to a potential adverse effect of this drug?

• A. Administering a cough suppressant
• B. Inserting a Foley catheter
• C. Administering an anti-diarrheal
• D. Monitoring urinary output

Correct answer: B

Rationale: Morphine can lead to urinary retention and urinary hesitancy. If a patient shows signs of bladder distention or inability to void, the healthcare provider should be notified, and urinary catheterization may be necessary. Administering a cough suppressant or an anti-diarrheal is not typically required to address adverse effects of morphine. Liver function tests (LFTs) are not directly related to the potential adverse effects of morphine on the urinary system.

5. A parent of a preschooler is being taught by a nurse about administering ear drops. Which of the following statements by the parent indicates an understanding of the teaching?

• A. I will straighten my child's ear canal by pulling it upward and backward.
• B. I will administer the ear drops immediately after removing them from the refrigerator.
• C. I will pull the ear lobe down and back before administering the ear drops.
• D. I will massage my child's ear after administering the ear drops.

Correct answer: D

Rationale: Correct administration of ear drops includes massaging the child's ear after administering the drops to facilitate proper absorption of the medication. This action helps ensure the effectiveness of the treatment. Choices A, B, and C are incorrect. Choice A describes incorrect positioning of the ear canal, choice B mentions incorrect storage of the ear drops, and choice C describes an incorrect technique for administering ear drops.

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