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 teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'

• A. keep medications in a medicine cabinet.
• B. have secured gates at entrances to staircases.
• C. move our child to a regular bed by the age of three.
• D. buy shoes that fasten with Velcro rather than laces.

Correct answer: C

Rationale: The correct answer is C. Moving a child to a regular bed by the age of three can increase the risk of falls as young toddlers may not have the motor skills to safely navigate a larger bed. This indicates a need for more teaching on safety measures. Choices A, B, and D are all appropriate safety measures that can help prevent accidents and injuries in young children. Keeping medications in a medicine cabinet, having secured gates at entrances to staircases, and choosing shoes that fasten with Velcro instead of laces are all good practices to ensure a safe environment for toddlers.

3. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but while waiting for the administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

• A. notify the practitioner
• B. measure abdominal girth
• C. auscultate for bowel sounds
• D. take vital signs, including blood pressure

Correct answer: A

Rationale: The passage of a normal brown stool in a child with intussusception could indicate spontaneous reduction of the intussusception. This change in the patient's condition is significant, requiring prompt notification of the practitioner for further evaluation and management. While measuring abdominal girth (Choice B) is important for assessing abdominal distention, it is not the priority when a potential spontaneous reduction may have occurred. Auscultating for bowel sounds (Choice C) and taking vital signs, including blood pressure (Choice D), are routine nursing assessments but do not address the immediate need to inform the practitioner of a possible change in the patient's condition that necessitates urgent attention.

4. What clinical manifestation of tetralogy of Fallot should the nurse expect when caring for children with this diagnosis?

• A. Slow respirations
• B. Clubbing of fingers
• C. Decreased RBC counts
• D. Subcutaneous hemorrhages

Correct answer: B

Rationale: The correct answer is B: Clubbing of fingers. Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. This condition causes the fingertips and nails to enlarge, creating a bulbous or club-like appearance. Slow respirations (Choice A) are not a typical clinical manifestation of tetralogy of Fallot. Decreased RBC counts (Choice C) may be seen in conditions like anemia but are not specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a characteristic clinical manifestation of tetralogy of Fallot.

5. What foods are appropriate for a 30-month-old toddler on a regular diet?

• A. Hamburger with bun and grapes
• B. Chicken fingers and french fries
• C. Hot dog with bun and potato chips
• D. Macaroni and cheese and Cheerios

Correct answer: D

Rationale: Macaroni and cheese and Cheerios are appropriate choices for a 30-month-old toddler on a regular diet. These foods are easy to chew, digest, and are generally well-liked by toddlers. Option A, a hamburger with bun and grapes, may be difficult for a toddler to handle due to the size of the hamburger and grapes pose a choking hazard. Option B, chicken fingers and french fries, may be too greasy and processed for a toddler's developing digestive system. Option C, hot dog with bun and potato chips, is also not ideal as hot dogs can be a choking hazard and potato chips are high in salt and may not provide adequate nutrition.

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