Nursing Elites

1. The mother of an 11-year-old boy with juvenile arthritis tells the nurse, 'I really don’t want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting.' Which information is most important for the nurse to provide this mother?

• A. Encouraging the child to rest when he experiences pain
• B. Encouraging quiet activities like watching television as a pain distractor
• C. Suggesting the use of hot baths as an alternative to pain medication
• D. Explaining that giving pain medication around the clock helps control the pain

Correct answer: D

Rationale: The nurse should educate the mother that giving pain medication around the clock helps maintain a consistent level of pain control, preventing severe pain episodes and improving the child's quality of life. It is essential to manage pain proactively rather than waiting for the child to be in severe pain before administering medication. Choices A, B, and C do not address the importance of proactive pain management and maintaining a consistent level of pain control. Encouraging rest, quiet activities, or hot baths as distractions or alternatives may not provide adequate pain relief for the child with juvenile arthritis, and they do not address the underlying issue of effective pain management.

2. The nurse is preparing to administer an immunization to a 5-year-old child. The parent asks if the vaccine can be given in a different way because the child is afraid of needles. What is the nurse’s best response?

• A. We can apply a numbing cream before the injection
• B. There is no other way to administer this vaccine
• C. We can give the vaccine as a nasal spray
• D. We can skip the vaccine if the child is too afraid

Correct answer: C

Rationale: Administering the vaccine as a nasal spray provides an alternative method of delivery that avoids the use of needles, addressing the child's fear while ensuring immunization. Nasal sprays are effective for certain vaccines and can be a suitable option in this scenario. Choice A is not the best response as it only addresses pain management but does not eliminate the use of needles. Choice B is incorrect as there are alternative delivery methods like nasal sprays. Choice D is incorrect as skipping the vaccine would leave the child unprotected and is not a recommended course of action.

3. Which statement by a school-aged client going to summer camp indicates the best understanding of the mode of transmission of Lyme disease?

• A. I'll cover my mouth with a wet cloth if there's too much dust blowing.
• B. Cuts and scrapes need to be washed out and covered right away.
• C. I'm not going to swim where the water is standing still or feels too hot.
• D. I have to wear long sleeves and pants when we're hiking around the pond.

Correct answer: D

Rationale: The correct answer is D. Wearing long sleeves and pants is an effective measure to prevent tick bites, which can transmit Lyme disease. Ticks are commonly found in wooded areas and tall grass, so covering exposed skin helps reduce the risk of tick bites and subsequently lowers the risk of contracting Lyme disease. Choices A, B, and C do not directly address the mode of transmission of Lyme disease. Option A pertains to respiratory protection against dust, Option B focuses on wound care, and Option C relates to water safety, none of which are directly related to preventing Lyme disease transmission.

4. A child with sickle cell anemia is being treated for a vaso-occlusive crisis. Which intervention should the practical nurse (PN) implement?

• A. Apply cold packs to painful areas.
• B. Encourage increased fluid intake.
• C. Administer high doses of vitamin C.
• D. Provide low-calorie meals.

Correct answer: B

Rationale: Encouraging increased fluid intake is crucial in managing vaso-occlusive crises in patients with sickle cell anemia. Dehydration can worsen these crises, so adequate hydration is essential to prevent complications and improve outcomes. Applying cold packs to painful areas may exacerbate vaso-occlusive crises by causing vasoconstriction. Administering high doses of vitamin C is not directly indicated for vaso-occlusive crises in sickle cell anemia. Providing low-calorie meals is not the priority during a vaso-occlusive crisis; maintaining adequate nutrition is important, but hydration takes precedence in this situation.

5. A child with leukemia is admitted for chemotherapy, and the nursing diagnosis 'altered nutrition, less than body requirements related to anorexia, nausea, and vomiting' is identified. Which intervention should the nurse include in this child's plan of care?

• A. Encourage a variety of large portions of food at every meal.
• B. Allow the child to eat any food desired and tolerated.
• C. Recommend eating the food as siblings eat at home.
• D. Restrict food brought from fast food restaurants.

Correct answer: B

Rationale: Allowing the child to eat any food desired and tolerated is the most appropriate intervention for a child with altered nutrition due to anorexia, nausea, and vomiting. It is crucial to prioritize maintaining adequate nutritional intake, and by allowing the child to choose foods they desire and can tolerate, the chances of improving their nutritional status increase. This approach helps in ensuring that the child receives necessary nutrients during chemotherapy, even if their appetite is affected by the treatment. Encouraging a variety of large portions of food at every meal (Choice A) may overwhelm the child and worsen their symptoms. Recommending eating the food as siblings eat at home (Choice C) may not align with the child's preferences and tolerances. Restricting food brought from fast food restaurants (Choice D) is not suitable as it may limit the child's options and preferences during a challenging time.

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