Nursing Elites

1. The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?

• A. I will ask the HCP for a psychiatric consult for your child'
• B. This type of acting out behavior is normal for adolescents'
• C. It is important to focus on your child’s needs at this difficult time'
• D. A reaction of anger is your child’s attempt to cope with this loss'

Correct answer: D

Rationale: Acknowledging the child's anger as part of the coping process helps the mother understand her child's emotional response.

2. A 2-year-old child with a history of frequent ear infections is brought to the clinic by the parents who are concerned about the child’s hearing. What should the nurse do first?

• A. Ask the parents about the child’s speech development
• B. Perform a hearing test
• C. Inspect the child’s ears for drainage
• D. Refer the child to an audiologist

Correct answer: C

Rationale: The most appropriate initial action for the nurse to take is to inspect the child's ears for drainage. This step can provide immediate information on the presence of infection or fluid, which could be impacting the child's hearing. By assessing for drainage, the nurse can gather valuable initial data to determine the next course of action, such as further evaluation or treatment. Asking about speech development or referring to an audiologist would be secondary steps after assessing the physical condition of the ears. Performing a hearing test would also be premature without first examining the ears for any visible issues.

3. While teaching a parenting class to new parents, the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors?

• A. Children need help in developing social skills.
• B. This age group fears loss of self-control.
• C. They provide the child with a sense of security.
• D. Children must learn to deal with authority.

Correct answer: C

Rationale: Implementing discipline and limit setting for infants and toddlers is primarily important as it provides them with a sense of security. This sense of security is crucial for their emotional and psychological development, helping them feel safe and supported as they explore the world around them. Choice A is incorrect because while developing social skills is important, the primary reason for discipline and limit setting in this context is to provide security. Choice B is incorrect as it does not address the main reason for implementing discipline and limit setting. Choice D is incorrect as the primary focus is not about dealing with authority at this early stage of development.

4. The healthcare provider is assessing an infant with diarrhea and lethargy. Which finding should the provider identify that is consistent with early dehydration?

• A. Tachycardia
• B. Bradycardia
• C. Dry mucous membranes
• D. Decreased skin turgor

Correct answer: A

Rationale: Tachycardia is a common early sign of dehydration in infants. It is important for healthcare providers to be vigilant in monitoring infants with these symptoms, as prompt intervention is crucial to prevent further complications.

5. The infant scheduled for reduction of intussusception passes a soft-formed brown stool the day before the scheduled procedure. Which intervention should the nurse implement?

• A. Instruct the parents that the infant needs to be NPO.
• B. Notify the healthcare provider of the passage of brown stool.
• C. Obtain a stool specimen for laboratory analysis.
• D. Ask the parents about recent changes in the infant's diet.

Correct answer: B

Rationale: Notifying the healthcare provider is crucial in this situation because the passage of a brown stool may indicate the resolution of intussusception. It is important to keep the healthcare provider informed about any changes in the infant's condition to ensure appropriate care and management. Instructing the parents that the infant needs to be NPO (nothing by mouth) is not necessary based on the passage of brown stool. Obtaining a stool specimen for laboratory analysis is not indicated in this scenario since the brown stool is likely a positive sign. Asking about recent changes in the infant's diet is not the priority at this moment as notifying the healthcare provider takes precedence.

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