Nursing Elites

1. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

2. As children grow and develop, their style of play changes. Which play style is descriptive of the school-age child?

• A. Plays alone but not with other children
• B. Plays games with other children and is able to follow the rules of the game
• C. Plays alone with play directed by others
• D. Plays with others in loose groups

Correct answer: B

Rationale: The correct answer is B. School-age children are typically able to play structured games with other children and follow the rules of the game. This ability reflects their growing cognitive and social development. Choice A is incorrect as school-age children often engage in group play. Choice C is incorrect as school-age children usually have more autonomy in their play choices. Choice D is incorrect as school-age children tend to form more organized play settings rather than loose groups.

3. What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?

• A. Children with ESRD usually adapt well to minor inconveniences of treatment.
• B. Children with ESRD require extensive support until they outgrow the condition.
• C. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
• D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.

Correct answer: D

Rationale: ESRD places significant stress on both the child and the family due to the ongoing need for dialysis, medications, and lifestyle restrictions, making it important for healthcare providers to offer extensive support and resources to manage these challenges.

4. A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample?

• A. Perform a new venipuncture to obtain the blood sample.
• B. Interrupt the IV fluid and withdraw the blood sample needed.
• C. Withdraw a blood sample equal to the amount of fluid in the device, discard, and then withdraw the sample needed.
• D. Flush the line and central venous device with saline and then aspirate the required amount of blood for the sample.

Correct answer: C

Rationale: Withdrawing and discarding a sample equal to the amount of fluid in the device ensures that the blood drawn is not diluted by the IV fluids, providing accurate lab results.

5. Which nursing intervention should be included in the postoperative care of a child following a tonsillectomy?

• A. Encourage the child to blow the nose gently
• B. Notify the physician if mucus is observed in the emesis
• C. Position the child supine in the immediate postoperative period
• D. Avoid giving citrus juice

Correct answer: D

Rationale: The correct answer is D: 'Avoid giving citrus juice.' Citrus juice can irritate the throat after a tonsillectomy, so it should be avoided. Choice A is incorrect because blowing the nose gently is not a recommended intervention following a tonsillectomy. Choice B is incorrect as mucus in emesis is not uncommon postoperatively and does not necessarily require physician notification. Choice C is incorrect as positioning the child supine immediately postoperatively can increase the risk of airway obstruction and should be avoided.

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