Nursing Elites

1. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?

• A. Instructing the parents to report adverse reactions to the growth hormone treatment
• B. Teaching the parents how to administer desmopressin acetate
• C. Informing the parents that treatment continues during puberty
• D. Educating the parents to report signs of acute adrenal crisis

Correct answer: B

Rationale: For a child with a disorder of the posterior pituitary gland, desmopressin acetate is a medication commonly used to manage the condition by replacing the antidiuretic hormone. Instructing the parents on how to administer desmopressin acetate correctly is essential for the child's care. Choice A is incorrect because growth hormone treatment is not typically used for posterior pituitary disorders. Choice C is incorrect as treatment for this condition usually continues beyond puberty. Choice D is incorrect as acute adrenal crisis is not directly related to a disorder of the posterior pituitary gland.

2. What are general guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion?

• A. Examining the child in the parent's arms
• B. Palpating the painful area of the abdomen first
• C. Placing the child supine and palpating the abdomen
• D. Separating the child from the parent to ensure a reliable examination

Correct answer: A

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is important to examine the child in the parent's arms. This approach helps reduce the child's anxiety, provides comfort, and can facilitate a more accurate assessment. Palpating the painful area of the abdomen first (choice B) may cause discomfort and increase anxiety in the child. Placing the child supine and palpating the abdomen (choice C) without considering the child's comfort and security may lead to resistance and inaccurate assessment. Separating the child from the parent to ensure a reliable examination (choice D) can further increase anxiety and hinder the assessment process. Therefore, examining the child in the parent's arms (choice A) is the most appropriate and effective approach in this scenario.

3. A nurse is teaching the parents of a child with a diagnosis of epilepsy about seizure precautions. What should the nurse include in the teaching?

• A. Keep a diary of seizure activity
• B. Administer antiepileptic medication only when a seizure occurs
• C. Restrict the child's activities to prevent seizures
• D. Teach seizure first aid to family members

Correct answer: D

Rationale: Teaching seizure first aid to family members is crucial for ensuring the child's safety during a seizure. Keeping a diary of seizure activity (choice A) is important for tracking patterns and triggers but does not directly relate to immediate safety during a seizure. Administering antiepileptic medication only when a seizure occurs (choice B) is incorrect as medications should be given as prescribed to maintain therapeutic levels. Restricting the child's activities to prevent seizures (choice C) is not an appropriate approach as it may limit the child's quality of life without guaranteeing seizure prevention.

4. The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include?

• A. Applying petroleum jelly to the dry skin.
• B. Rubbing the skin vigorously to remove the dead skin.
• C. Soaking the area in warm water every day.
• D. Washing the skin with diluted peroxide and water.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the teaching plan is to advise the child to soak the area in warm water every day. Soaking the area in warm water helps to gently remove dead skin without causing irritation, facilitating the safe and comfortable removal of the cast. Applying petroleum jelly (Choice A) may not be necessary and could interfere with the cast removal process. Rubbing the skin vigorously (Choice B) can lead to skin damage and should be avoided. Washing the skin with diluted peroxide and water (Choice D) is not recommended as peroxide can be irritating to the skin and may not aid in cast removal.

5. During a routine monthly examination, a 5-month-old infant is brought to the pediatric clinic. What assessment finding should alert the nurse to notify the health care provider?

• A. Temperature of 99.5°F
• B. Blood pressure of 75/48 mm Hg
• C. Heart rate of 100 beats per minute
• D. Respiratory rate of 50 breaths per minute

Correct answer: D

Rationale: A respiratory rate of 50 breaths per minute in a 5-month-old infant is considered high and may indicate respiratory distress. Infants normally have a higher respiratory rate than older children and adults, but a rate of 50 breaths per minute is above the expected range. This finding warrants immediate attention as it may be indicative of an underlying respiratory issue or distress. Choice A (Temperature of 99.5°F) is within the normal range for body temperature and does not necessarily indicate a critical issue. Choice B (Blood pressure of 75/48 mm Hg) is not typically assessed in isolation for a 5-month-old infant during a routine examination, and the values provided are not indicative of a critical condition. Choice C (Heart rate of 100 beats per minute) is within the normal range for heart rate in infants and may not be a cause for immediate concern during a routine examination.

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