Nursing Elites

1. During a physical examination of a 9-month-old baby, the nurse observes a flat, discolored area on the skin. The nurse documents this as a:

• A. Papule.
• B. Macule.
• C. Vesicle.
• D. Scale.

Correct answer: B

Rationale: The correct answer is B: Macule. A macule is a flat, discolored area on the skin that is smaller than 1 cm in diameter. This term is used to describe conditions like freckles or petechiae. Choice A, Papule, refers to a small, solid, raised skin lesion (<0.5 cm) like a pimple. Choice C, Vesicle, describes a small blister filled with clear fluid. Choice D, Scale, refers to flakes or plates of dead skin that may be dry or greasy.

2. When teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration, what should the nurse emphasize?

• A. Rotate injection sites
• B. Administer insulin before meals
• C. Store insulin in the refrigerator
• D. Administer insulin at bedtime

Correct answer: A

Rationale: The correct answer is to rotate injection sites. This practice helps prevent lipodystrophy, a localized loss of fat tissue that can affect insulin absorption. By rotating sites, the child can avoid developing lumps or indentations in the skin where insulin is repeatedly injected. Administering insulin before meals (choice B) may be necessary for certain types of insulin but is not the priority when teaching about insulin administration. Storing insulin in the refrigerator (choice C) is important for maintaining its potency, but it is not the primary emphasis when teaching about insulin administration. Administering insulin at bedtime (choice D) may be necessary based on the child's insulin regimen but is not the primary consideration for teaching injection techniques and site rotation.

3. A 4-year-old child is admitted to the hospital with a diagnosis of epiglottitis. What is the priority nursing intervention?

• A. Administer antibiotics
• B. Provide humidified oxygen
• C. Keep the child NPO
• D. Position the child upright

Correct answer: C

Rationale: The priority nursing intervention for a 4-year-old child admitted to the hospital with epiglottitis is to keep the child NPO (nothing by mouth). Epiglottitis is a serious condition that can lead to airway obstruction. Keeping the child NPO helps prevent further compromise of the airway and reduces the risk of aspiration. Administering antibiotics may be necessary but ensuring the airway is not compromised takes precedence. Providing humidified oxygen is important for respiratory support, but not the priority over maintaining a patent airway. Positioning the child upright can help with breathing and comfort, but it does not directly address the immediate risk of airway compromise associated with epiglottitis.

4. The nurse is teaching a father how to stimulate his 7-year-old son, who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?

• A. Telling him to read stories to the child about famous athletes
• B. Suggesting he take the child to watch him play softball
• C. Urging him to sign the child up for little league football
• D. Proposing wrestling with the child and letting him win

Correct answer: A

Rationale: The correct answer is A. Reading stories to the child about famous athletes would be the most successful guidance for a child with a 'slow-to-warm-up' temperament. This approach allows for a less active and more acceptable way of engaging with the child, aligning better with the child's temperament. Choices B, C, and D involve more active and potentially overwhelming activities for a child with such a temperament, which may not be as effective in stimulating and engaging the child.

5. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?

• A. Mental retardation
• B. Inherited genetic factors
• C. Delayed physical growth
• D. Clubbing of the fingertips

Correct answer: C

Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.

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