Nursing Elites

1. What should be the focus of nursing activity for the mother of an 8-year-old girl with a broken arm, who is the nurturer in the family?

• A. Teaching proper care procedures
• B. Dealing with insurance coverage
• C. Determining the success of treatment
• D. Transmitting information to family members

Correct answer: A

Rationale: The correct answer is A: Teaching proper care procedures. In this scenario, focusing on teaching the mother proper care procedures is crucial as she is the nurturer in the family and will likely be the primary caregiver for the child. This will empower her to provide appropriate care and support for her daughter during the recovery process. Choices B, C, and D are not the most appropriate activities for the mother in this situation. Dealing with insurance coverage, determining treatment success, and transmitting information to family members are important but not as directly relevant to the immediate care needs of the child's broken arm.

2. 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: Clubbing of fingers is a common manifestation in children with tetralogy of Fallot due to chronic hypoxia. Clubbing occurs as a result of long-standing decreased oxygen levels in the blood, leading to changes in the fingertips. Slow respirations (Choice A) are not typically a direct clinical manifestation of tetralogy of Fallot. While decreased RBC counts (Choice C) may occur due to chronic hypoxia, they are not a primary manifestation specific to tetralogy of Fallot. Subcutaneous hemorrhages (Choice D) are not a common clinical manifestation associated with tetralogy of Fallot.

3. A mother confides to the nurse that she is thinking of divorce. Which suggestion by the nurse would help minimize the effects on the child?

• A. Tell the child together using appropriate terms.
• B. Reassure the child that no one loves him more than his parents.
• C. Engage in special activities with the child to compensate for the divorce.
• D. Keep your feelings to yourself and maintain a positive facade with the child.

Correct answer: A

Rationale: In situations of divorce, it is crucial for both parents to inform the child together using age-appropriate language. This approach helps maintain consistency and clarity for the child, reducing confusion and anxiety. Choice B is incorrect because reassurance should not be solely focused on love but on explaining the situation appropriately. Choice C may inadvertently send the message that the divorce is the child's fault or requires compensation. Choice D is incorrect as children benefit from understanding and processing emotions in a healthy manner, rather than having them kept hidden.

4. What is the priority nursing responsibility when a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure?

• A. Apply restraints.
• B. Administer oxygen.
• C. Protect the child from self-injury.
• D. Insert a plastic airway in the child’s mouth.

Correct answer: C

Rationale: During a tonic-clonic seizure, the priority nursing responsibility is to protect the child from self-injury. Applying restraints is not recommended during a seizure as it can lead to further harm. Administering oxygen may be necessary after the seizure to support oxygenation, but it is not the priority during the seizure itself. Inserting a plastic airway is also not indicated as the jaw is clamped, and the child should not have anything placed in the mouth during a seizure. Therefore, the correct action is to ensure the child's safety by protecting them from self-injury, preventing harm from uncontrolled movements and potential falls.

5. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.

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