Nursing Elites

1. The healthcare provider is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?

• A. Laughs readily, turns from back to side.
• B. Has strong Moro and tonic neck reflexes.
• C. Keeps fists clenched, opens hands when grasping an object.
• D. Can lift head, but not chest when lying on abdomen.

Correct answer: A

Rationale: In infants, laughing readily and turning from back to side are indicative of normal development. These behaviors indicate that the thyroid therapy is effective, as they suggest the baby is achieving age-appropriate milestones. A 5-month-old infant should be able to laugh readily and turn from back to side, showing progress in motor and social development. Choices B, C, and D describe behaviors that are not specific to the expected developmental milestones of a 5-month-old. Strong Moro and tonic neck reflexes, clenched fists, and limited ability to lift the chest when lying on the abdomen are not necessarily indicative of the effectiveness of thyroid therapy for hypothyroidism.

2. A child with a fever of 39°C (102.2°F) and a sore throat is brought to the clinic. The practical nurse suspects the child has streptococcal pharyngitis. Which diagnostic test should the practical nurse prepare the child for?

• A. Rapid antigen detection test.
• B. Throat culture.
• C. Complete blood count (CBC).
• D. Chest X-ray.

Correct answer: A

Rationale: A rapid antigen detection test is the appropriate diagnostic test for suspected streptococcal pharyngitis. This test is commonly used due to its quick results, helping in the prompt diagnosis and appropriate treatment of the condition. It specifically detects the presence of streptococcal antigens in the throat, aiding in confirming the diagnosis and guiding the healthcare provider in determining the most suitable treatment plan. Throat culture (Choice B) is a confirmatory test but is not as rapid as the rapid antigen detection test. Complete blood count (Choice C) and Chest X-ray (Choice D) are not specific tests for streptococcal pharyngitis and would not aid in confirming the diagnosis.

3. The healthcare provider is preparing a teaching plan for the parents of a 6-month-old infant with GERD. What instruction should the healthcare provider include when teaching the parents measures to promote adequate nutrition?

• A. Alternate glucose water with formula
• B. Mix the formula with rice cereal
• C. Add multivitamins with iron to the formula
• D. Use water to dilute the formula

Correct answer: B

Rationale: The correct instruction for promoting adequate nutrition in a 6-month-old infant with GERD is to mix the formula with rice cereal. This thickens the feed, reducing the risk of reflux, aiding in proper nutrition, and minimizing GERD symptoms. Choices A, C, and D are incorrect. Alternating glucose water with formula, adding multivitamins with iron to the formula, or diluting the formula with water are not recommended measures for promoting adequate nutrition in infants with GERD.

4. What information should be reinforced with the parents of a school-aged child about Reye's syndrome?

• A. Vaccinate your child before the age of 7 against Reye's syndrome.
• B. Keep the child at home for 2 days after the symptoms appear.
• C. Avoid giving any medication containing aspirin during a viral illness.
• D. Do not provide any citrus juices during a bacterial or viral illness.

Correct answer: C

Rationale: The correct answer is C: 'Avoid giving any medication containing aspirin during a viral illness.' It is crucial to advise parents to avoid giving any medication containing aspirin during a viral illness to prevent Reye's syndrome. Reye's syndrome is a rare but serious condition linked to the use of aspirin during viral illnesses in children and teenagers. Choices A, B, and D are incorrect because vaccinating against Reye's syndrome is not applicable as there is no specific vaccine for it, keeping the child at home for 2 days after symptoms appear is not a preventive measure for Reye's syndrome, and avoiding citrus juices is not directly related to the prevention of Reye's syndrome.

5. The nurse is providing care for a 12-year-old child who was recently diagnosed with scoliosis. The child’s parent asks about treatment options. What is the nurse’s best response?

• A. Scoliosis can be corrected with exercises and physical therapy.
• B. Bracing is often recommended to prevent further curvature of the spine.
• C. Surgery is usually necessary for all cases of scoliosis.
• D. There is no effective treatment for scoliosis.

Correct answer: B

Rationale: Bracing is commonly used in moderate cases of scoliosis to prevent progression of the spinal curvature. Choice A is incorrect because exercises and physical therapy can help manage scoliosis but may not correct it. Choice C is incorrect as surgery is usually reserved for severe cases of scoliosis that do not respond to other treatments. Choice D is incorrect because there are effective treatments available for scoliosis, such as bracing, and surgery when necessary.

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