Nursing Elites

1. The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'? What is the nurse's best response?

• A. They are going to fix you up 'down there'.
• B. They will move your testicle from your abdomen to your scrotum.
• C. What do you think your doctor is going to do?
• D. You shouldn't worry. Your doctor knows exactly what to do.

Correct answer: C

Rationale: The nurse should encourage the child to express his thoughts and feelings about the upcoming surgery. This approach helps the child feel heard and understood while providing an opportunity to address any misconceptions or fears. By asking the child what he thinks the doctor will do, the nurse engages the child in a conversation that can help alleviate anxiety and build trust. School-age children often have fears related to bodily harm, and open communication can help alleviate such concerns. Choices A and D do not encourage open communication or address the child's concerns directly. Choice B provides too much detail that may overwhelm the child and is not age-appropriate for a 6-year-old.

2. A healthcare provider is assessing the pain level of a three-year-old toddler. Which of the following pain assessment scales should the healthcare provider use?

• A. FACES Pain rating scale
• B. Numeric pain rating scale
• C. CRIES pain assessment scale
• D. Non-communicating children's pain checklist

Correct answer: A

Rationale: The healthcare provider should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale allows the toddler to point to the face that depicts the current level of pain, making it a suitable choice for non-verbal or young children who may have difficulty expressing their pain verbally.

3. A school-age child is 4 hours postoperative following perforated appendicitis repair. Which of the following actions should the nurse take?

• A. Maintain the child on a clear liquid diet for 48 hours.
• B. Administer antibiotics for 7 days.
• C. Apply warm compresses to the surgical site every 4 hours.
• D. Keep the child on NPO status for 24 hours.

Correct answer: B

Rationale: Administering antibiotics for 7 days is essential postoperatively to prevent infections and complications in a child who underwent perforated appendicitis repair. This helps in reducing the risk of secondary infections and promoting healing. Clear liquid diets, warm compresses, and prolonged fasting are not the primary interventions indicated in this scenario.

4. A parent of a child with cystic fibrosis is being taught about dietary guidelines. Which statement by the parent indicates an understanding of the teaching?

• A. My child should eat a high-calorie, high-protein diet.
• B. My child should avoid eating eggs.
• C. My child should follow a low-fat, low-sodium diet.
• D. My child should follow a high-fiber, high-protein diet.

Correct answer: A

Rationale: The correct answer is A. For a child with cystic fibrosis, a high-calorie, high-protein diet is recommended to meet the increased metabolic needs associated with the condition. The protein helps with growth and repair, while the extra calories help compensate for malabsorption and increased energy requirements. Choice B is incorrect because eggs are a good source of protein and essential nutrients unless the child has a specific allergy. Choice C is incorrect as a low-fat, low-sodium diet is not typically recommended for children with cystic fibrosis who need higher calorie and fat intake. Choice D is incorrect because while a high-protein diet is beneficial, a high-fiber diet may not be suitable for a child with cystic fibrosis due to potential gastrointestinal issues.

5. A parent of a child with celiac disease is receiving teaching from a nurse. Which of the following statements should the nurse make?

• A. You should give your child vitamin supplements that contain iron.
• B. Your child will need a gluten-free diet.
• C. Your child should consume large amounts of dietary fiber.
• D. Your child can resume eating whole wheat bread.

Correct answer: B

Rationale: The correct answer is B. Celiac disease requires a strict gluten-free diet to manage the condition effectively. Gluten-containing foods like wheat, barley, and rye must be avoided to prevent intestinal damage and symptoms in individuals with celiac disease. Therefore, the nurse should emphasize the importance of a gluten-free diet to the parent of the child with celiac disease.

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