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. While teaching a parent how to prevent accidents while caring for a 6-month-old infant, what motor development ability should be emphasized?

• A. Sits up
• B. Rolls over
• C. Crawls short distances
• D. Stands while holding on to furniture

Correct answer: B

Rationale: The correct answer is B: Rolls over. At 6 months, most infants can roll over, increasing the risk of falls. It is important to emphasize to the parent the need for careful supervision to prevent accidents. While choices A, C, and D are also milestones in infant motor development, rolling over at this age poses a higher risk of accidents due to the increased mobility and potential for falls.

3. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?

• A. Dislocated radial head
• B. Transient synovitis of the hip
• C. Osgood-Schlatter disease
• D. Scoliosis

Correct answer: C

Rationale: The correct answer is C: Osgood-Schlatter disease. This condition is a common overuse injury that affects the knee. Osgood-Schlatter disease typically occurs in children and adolescents who are involved in activities that require frequent running, jumping, and kicking. It is characterized by pain, swelling, and tenderness at the tibial tuberosity, where the patellar tendon inserts into the tibia. Choice A, Dislocated radial head, is not an overuse disorder but rather a form of elbow injury where the head of the radius bone is displaced from its normal position. Choice B, Transient synovitis of the hip, is a self-limiting condition that causes hip pain and limping in children. It is not typically considered an overuse disorder. Choice D, Scoliosis, is a condition characterized by an abnormal lateral curvature of the spine. While it may be related to certain activities or postures, it is not primarily classified as an overuse disorder.

4. What is the most common cause of shock (hypoperfusion) in infants and children?

• A. infection
• B. cardiac failure
• C. accidental poisoning
• D. severe allergic reaction

Correct answer: A

Rationale: Infection is the most common cause of shock in infants and children due to their increased susceptibility to sepsis. Infants and children have underdeveloped immune systems, making them more prone to infections that can lead to septic shock. While cardiac failure is a serious condition, it is not the most common cause of shock in this population. Accidental poisoning, though dangerous, is less common than infection in causing shock in infants and children. Severe allergic reactions can lead to anaphylactic shock, but they are not as prevalent as infections in causing shock in this age group.

5. The nurse is obtaining a health history from parents of a 4-month-old boy with congenital hypothyroidism. What would the nurse most likely assess?

• A. The child's growth is above normal for his age.
• B. The child is active and playful.
• C. The skin appears pink and healthy.
• D. It is difficult to keep the child awake.

Correct answer: D

Rationale: The correct answer is D. Congenital hypothyroidism in infants often leads to lethargy and difficulty staying awake due to low thyroid hormone levels. Assessing the child's ability to stay awake is crucial in identifying signs of hypothyroidism. Choices A, B, and C are incorrect because above-normal growth, being active and playful, and having healthy-looking skin are not typical manifestations of congenital hypothyroidism. Instead, infants with hypothyroidism may exhibit poor weight gain, decreased activity, and dry, pale skin.

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