Nursing Elites

1. The mother of an infant diagnosed with bronchiolitis asks the nurse what causes the disease. How should the nurse respond?

• A. Respiratory syncytial virus (RSV)
• B. Haemophilus influenzae
• C. Parainfluenza
• D. Rotavirus

Correct answer: A

Rationale: The correct answer is A: Respiratory syncytial virus (RSV). RSV is the most common cause of bronchiolitis, especially in infants. Bronchiolitis is characterized by inflammation of the small airways in the lungs. Choice B, Haemophilus influenzae, is a bacterium that can cause respiratory infections but is not the primary cause of bronchiolitis. Choice C, Parainfluenza, is a common viral infection that can cause croup and other respiratory illnesses but is not the main cause of bronchiolitis. Choice D, Rotavirus, is a virus that primarily affects the gastrointestinal system, causing diarrhea and vomiting, and is not associated with bronchiolitis.

2. An important role of the nurse in ambulatory settings and schools is the identification of communicable diseases for treatment and the prevention of spread. What is an important component related to the first period of the contagiousness of disease?

• A. Source
• B. Causative agent
• C. Prodromal stage
• D. Constitutional symptoms

Correct answer: C

Rationale: The prodromal period is the interval between the early manifestations of the disease and the time when the overt clinical syndrome is evident. Most communicable diseases are contagious during this time. Identifying the prodromal stage is crucial for early intervention and preventing the spread of the disease. While the source and causative agent are important aspects of disease control, recognizing the early signs in the prodromal stage allows the nurse to take timely actions. Constitutional symptoms occur during the active disease phase, indicating that the child has already been contagious, and early intervention opportunities may have passed.

3. Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play is this?

• A. Cooperative play
• B. Solitary play
• C. Parallel play
• D. Associative play

Correct answer: C

Rationale: The correct answer is C, parallel play. Parallel play is observed when children play alongside each other but do not directly interact. In this scenario, each child is engaged in their own activity without engaging or influencing each other's play, which characterizes parallel play. Cooperative play (choice A) involves children playing together towards a common goal, which is not evident in the given situation. Solitary play (choice B) is when a child plays alone, unrelated to the presence of others. Associative play (choice D) involves more interaction and sharing of toys between children, which is not happening in the described play scenario.

4. At what age is binocularity, the ability to fixate on one visual field with both eyes simultaneously, typically achieved?

• A. 1 month
• B. 3 to 4 months
• C. 6 to 8 months
• D. 12 months

Correct answer: B

Rationale: Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is typically achieved by the age of 3 to 4 months. Achieving binocularity at 1 month is too early for most infants as their visual system is still developing. Similarly, 6 to 8 months and 12 months are beyond the normal age range for achieving binocularity, and delayed achievement could indicate potential issues like strabismus, which may lead to visual impairment if not addressed.

5. A child diagnosed with a soft tissue tumor is being treated with chemotherapy. Prior to administering the chemotherapy, which laboratory test should the nurse monitor to determine if the child has any capability of fighting infections?

• A. Hemoglobin
• B. Red blood cell count
• C. Platelets
• D. Absolute neutrophil count (ANC)

Correct answer: D

Rationale: The Absolute Neutrophil Count (ANC) is crucial for determining the child's ability to fight infections. Neutrophils play a key role in combating bacterial infections. Monitoring the ANC is essential before administering chemotherapy, as a low ANC indicates an increased risk of infection. Hemoglobin, red blood cell count, and platelets are important for assessing oxygen-carrying capacity, anemia, and clotting function, respectively, but they do not directly reflect the child's capability to fight infections.

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