Nursing Elites

1. During a check-up for a 5-year-old child with eczema before school starts, what will the nurse do?

• A. Change the bandage on a cut on the child’s hand.
• B. Assess the compliance with treatment regimens.
• C. Discuss systemic corticosteroid therapy.
• D. Assess the child’s fluid volume.

Correct answer: B

Rationale: Assessing compliance with treatment regimens is crucial in managing eczema effectively and preventing flare-ups. This involves ensuring that the child is following the prescribed treatment plan, which may include medication application, skincare routines, and lifestyle modifications. Changing a bandage on a cut would not be a routine part of an eczema check-up unless there was a specific wound related to eczema. Discussing systemic corticosteroid therapy may be part of the management plan for severe eczema cases but would not be the primary focus during a routine check-up. Assessing the child’s fluid volume, while important in general health assessments, is not directly related to managing eczema specifically.

2. When a child with a diagnosis of asthma is prescribed a peak flow meter, what should the nurse teach the child and parents about using this device?

• A. Use the device before taking medication
• B. Use the device during asthma attacks
• C. Record the best of three attempts
• D. Use the device after eating

Correct answer: C

Rationale: The correct answer is to record the best of three attempts when using a peak flow meter. This method provides a more accurate measure of peak expiratory flow. Choice A is incorrect because using the device before taking medication may not reflect the actual peak flow, as medication can affect lung function. Choice B is incorrect as using the device during asthma attacks may not be feasible or safe, as the focus during an attack should be on managing symptoms rather than measuring peak flow. Choice D is incorrect because using the device after eating may not provide an accurate measurement of peak flow, as digestion can affect lung function temporarily.

3. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

• A. They will increase tidal volumes.
• B. Drainage of air and fluid will be facilitated.
• C. They will maintain positive intrapleural pressure.
• D. Pressure on the pericardium and chest wall will be regulated.

Correct answer: B

Rationale: Chest tubes are necessary after open-heart surgery to facilitate the drainage of air and fluid from the chest cavity. These tubes help prevent complications such as pneumothorax (accumulation of air in the pleural space) or cardiac tamponade (build-up of fluid in the pericardial sac), which can be serious postoperative issues. Options A, C, and D are incorrect because chest tubes are primarily used for draining purposes and not for increasing tidal volumes, maintaining positive intrapleural pressure, or regulating pressure on the pericardium and chest wall.

4. After the nurse has completed an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?

• A. Before starting school
• B. Within the next few months
• C. When the first deciduous teeth are lost
• D. At the next dental check-up for a family member

Correct answer: B

Rationale: The most appropriate time for a child to first visit the dentist is within the next few months after turning two years old. This visit allows the dentist to assess the child's oral health, provide guidance on proper oral hygiene practices, and establish a positive relationship with dental care. Choice A (Before starting school) is not as specific and timely as the recommended age of 2 years. Choice C (When the first deciduous teeth are lost) is not ideal as preventive dental visits should start earlier to establish good oral health habits. Choice D (At the next dental check-up for a family member) may delay the child's first dental visit, missing the opportunity for early preventive care and guidance.

5. Why might a healthcare provider question a health care provider's order for a tap water enema for a 6-month-old infant with suspected Hirschsprung disease?

• A. The result could lead to loss of necessary nutrients.
• B. It could cause a fluid and electrolyte imbalance.
• C. It could increase the fear of intrusive procedures.
• D. The result could cause shock from a sudden drop in temperature.

Correct answer: B

Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas are unlikely to lead to loss of necessary nutrients. Choice C is incorrect as it does not directly relate to the physiological risk of tap water enemas. Choice D is incorrect as shock from a sudden drop in temperature is not a common concern with tap water enemas.

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