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. When reinforcing information about the use of corticosteroids in treating asthma in children, which statement indicates that the parent understands the teaching?

• A. My child should take the medication only when experiencing symptoms.
• B. I will rinse my child's mouth after each use of the inhaler.
• C. I should discontinue the medication if my child seems better.
• D. Corticosteroids are used for quick relief during an asthma attack.

Correct answer: B

Rationale: Rinsing the mouth after using corticosteroid inhalers is crucial as it helps prevent oral thrush, a common side effect associated with these medications. This practice reduces the risk of developing fungal infections in the mouth and throat, maintaining optimal oral health during asthma treatment.

3. Why is honest information important in building a trusting relationship with adolescent patients?

• A. Encourage the adolescent to seek help outside of the school clinic.
• B. Keep disclosures from the adolescent confidential.
• C. Honest information ensures establishing a trusting relationship.
• D. Discourage minor adolescents from disclosing private concerns.

Correct answer: C

Rationale: Honesty is fundamental in building trust with adolescent patients as it helps create an environment where they feel safe to share their concerns openly. By being honest and maintaining confidentiality, healthcare providers can establish a strong and trusting relationship with adolescents, ultimately leading to better healthcare outcomes.

4. The healthcare provider is preparing to administer a vaccine to a 5-year-old child. The child is visibly anxious and asks if the shot will hurt. What is the healthcare provider’s best response?

• A. It might hurt a little, but it will be over quickly
• B. It won't hurt at all, don't worry
• C. You're a big kid now, and big kids don't cry
• D. If you don't think about it, it won't hurt

Correct answer: A

Rationale: When a child expresses fear or anxiety about receiving a vaccination, it is essential for the healthcare provider to provide honest and reassuring information. Choice A acknowledges the potential for some discomfort but also reassures the child that it will be over quickly. This response validates the child's feelings while also preparing them for the procedure. Choices B, C, and D either provide false reassurance, dismiss the child's feelings, or suggest avoidance, which are not appropriate responses in this situation.

5. An adolescent female who is leaning forward with her hands on her knees to breathe tells the practical nurse that she has been using triamcinolone (Azmacort) inhalation aerosol before coming to the clinic. Which action should the PN implement?

• A. Obtain vital signs and assess breath sounds for wheezing.
• B. Collect a blood sample for white blood cell count.
• C. Give the client a nebulizer breathing treatment.
• D. Administer another dose of Azmacort.

Correct answer: A

Rationale: When a patient presents with breathing difficulties, the first action should be to assess vital signs and breath sounds to evaluate the severity of the condition. This assessment will provide crucial information to determine the appropriate course of action and treatment. Collecting a blood sample for a white blood cell count, giving a nebulizer treatment, or administering another dose of Azmacort would not be the initial priority in this situation. Therefore, option A is the correct choice as it focuses on assessing the patient's respiratory status to guide further interventions.

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