Nursing Elites

1. The nurse is planning the care of a hospitalized 4-year-old. The most appropriate technique the nurse can use to reduce the stress of hospitalization for this child is to:

• A. Encourage the child to discuss their feelings.
• B. Encourage peer visitation.
• C. Encourage the child to play with safe medical equipment.
• D. Read a story to the child.

Correct answer: C

Rationale: Encouraging the child to play with safe medical equipment is the most appropriate technique to reduce stress for a hospitalized child. This technique helps familiarize the child with medical equipment in a non-threatening way, empowering them to feel more in control of the environment. Options A, B, and D may be helpful but do not directly address the child's exposure and interaction with the hospital environment, making them less effective in reducing stress in this context.

2. After providing home care instructions to the mother of a child being discharged following cardiac surgery, which statement made by the mother indicates a need for further instructions?

• A. A balance of rest and exercise is important.
• B. I can apply lotion or powder to the incision if it is itchy.
• C. Activities in which falling could occur need to be avoided for two to four weeks.
• D. Large crowds of people need to be avoided for at least two weeks after the surgery.

Correct answer: B

Rationale: The correct answer is B. The mother stating that she can apply lotion or powder to the incision if it is itchy indicates a need for further instructions. Applying lotion or powder to the incision is not recommended as it can increase the risk of infection. The other choices are correct: A) Balancing rest and exercise is important for recovery, C) avoiding activities where falling could occur is necessary to prevent injury, and D) avoiding large crowds helps reduce the risk of infections during the initial recovery period.

3. A 4-year-old boy with a tracheostomy tube is experiencing respiratory distress. He has intercostal retractions, a heart rate of 80 beats/min, and an oxygen saturation of 85%. During his attempts to breathe, a gurgling sound is heard in the tracheostomy tube. You should:

• A. Ventilate through the tracheostomy tube.
• B. Place an oxygen mask over the tracheostomy tube.
• C. Remove the tracheostomy tube and clean it.
• D. Carefully suction the tracheostomy tube.

Correct answer: D

Rationale: In this scenario, the 4-year-old boy with a tracheostomy tube is showing signs of respiratory distress, including intercostal retractions, a low heart rate, and decreased oxygen saturation. The gurgling sound indicates a possible airway obstruction. Correctly, the immediate action should be to carefully suction the tracheostomy tube. Suctioning can help clear any secretions or obstructions, thus improving the child's ability to breathe effectively. Ventilating through the tube, placing an oxygen mask over it, or removing and cleaning the tube would not address the potential obstruction and could worsen the respiratory distress.

4. Which of the following is not an infectious cause of diarrhea?

• A. Allergy
• B. Bacteria
• C. Parasite
• D. Virus

Correct answer: A

Rationale: The correct answer is A: Allergy. Allergy is not an infectious cause of diarrhea. Diarrhea caused by bacteria, parasites, and viruses is due to infection, while an allergy triggers an immune response that can lead to diarrhea but is not caused by an infectious agent. Choices B, C, and D are incorrect because bacteria, parasites, and viruses are known infectious causes of diarrhea, resulting from infections by these microorganisms.

5. Beta-adrenergic agonists such as albuterol are given to Reggie, a child with asthma, to primarily do which of the following?

• A. Dilate the bronchioles
• B. Reduce secondary infections
• C. Decrease postnasal drip
• D. Reduce airway inflammation

Correct answer: A

Rationale: Beta-adrenergic agonists like albuterol are bronchodilators that primarily work by relaxing and dilating the bronchioles, which helps to alleviate bronchoconstriction, a characteristic feature of asthma. This action leads to improved airflow and easier breathing for individuals experiencing asthma symptoms.

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