Nursing Elites

1. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

• A. Limit explanation of procedures because the child is preschool-aged
• B. Ask that all family members leave the room when performing procedures
• C. Allow the child to choose the type of juice to drink with the administration of oral medications
• D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective

Correct answer: C

Rationale: Allowing the child to make choices, such as selecting the type of juice, helps to maintain a sense of control and reduce anxiety, ensuring atraumatic care.

2. The parents of an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?

• A. Your infant will not need any subsequent follow-up care
• B. Your infant will only need to be evaluated by an audiologist
• C. Your infant will only need follow-up with a speech pathologist
• D. Your infant will need follow-up with audiologists and orthodontists

Correct answer: D

Rationale: After cleft palate repair, the child will need ongoing follow-up with audiologists, speech pathologists, and orthodontists to monitor hearing, speech development, and dental alignment.

3. What is the primary treatment for Kawasaki disease?

• A. Corticosteroids
• B. Intravenous immunoglobulin
• C. Antibiotics
• D. Antivirals

Correct answer: B

Rationale: The correct answer is B, Intravenous immunoglobulin (IVIG). IVIG is the primary treatment for Kawasaki disease, an acute vasculitis that mainly affects children under 5 years old. Early administration of IVIG is crucial as it helps reduce the risk of coronary artery aneurysms, which is the most serious complication of Kawasaki disease. Corticosteroids (Choice A) are not the primary treatment for Kawasaki disease and are not recommended due to potential adverse effects. Antibiotics (Choice C) are not indicated for the treatment of Kawasaki disease as it is not caused by a bacterial infection. Antivirals (Choice D) are also not part of the standard treatment for Kawasaki disease, as it is not caused by a viral infection.

4. In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.)

• A. Oliguric renal failure
• B. Increased intracranial pressure
• C. Mechanical ventilation
• D. All above

Correct answer: D

Rationale: Conditions like oliguric renal failure, increased intracranial pressure, and mechanical ventilation significantly alter fluid requirements in children. These conditions either restrict fluid output or require careful fluid management to avoid worsening the condition.

5. What is the best indicator of fluid balance in a pediatric patient?

• A. Blood pressure
• B. Heart rate
• C. Weight
• D. Urine output

Correct answer: C

Rationale: Weight is the most accurate indicator of fluid balance in pediatric patients. Changes in weight reflect shifts in body fluid levels more directly compared to other parameters. Blood pressure and heart rate may be affected by various factors other than fluid balance. While urine output is important in assessing renal function, it may not provide a comprehensive picture of overall fluid balance in pediatric patients.

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