Nursing Elites

1. The healthcare professional is preparing to administer an immunization to a four-year-old child. Which of the following actions should the professional plan to take?

• A. Place the child in a prone position for the immunization
• B. Request that the child's caregiver stay in the room during the immunization
• C. Administer the immunization using a 24-gauge needle
• D. Inject the immunization slowly without aspirating

Correct answer: C

Rationale: When administering an immunization to a four-year-old child, it is important to use a 24-gauge needle to minimize pain and discomfort for the child. Thicker needles can cause more pain and tissue trauma. Using a thinner needle like a 24-gauge is appropriate for pediatric immunizations. Placing the child in a prone position for immunization is not recommended as it can be uncomfortable and may not allow for proper access to the injection site. Having the caregiver stay in the room during the immunization is beneficial for support and comfort for the child. Injecting the immunization slowly without aspirating is correct, as aspirating before administering the immunization is not required for intramuscular injections in current practice.

2. A parent of a child with cystic fibrosis is being taught about dietary guidelines. Which statement by the parent indicates an understanding of the teaching?

• A. My child should eat a high-calorie, high-protein diet.
• B. My child should avoid eating eggs.
• C. My child should follow a low-fat, low-sodium diet.
• D. My child should follow a high-fiber, high-protein diet.

Correct answer: A

Rationale: The correct answer is A. For a child with cystic fibrosis, a high-calorie, high-protein diet is recommended to meet the increased metabolic needs associated with the condition. The protein helps with growth and repair, while the extra calories help compensate for malabsorption and increased energy requirements. Choice B is incorrect because eggs are a good source of protein and essential nutrients unless the child has a specific allergy. Choice C is incorrect as a low-fat, low-sodium diet is not typically recommended for children with cystic fibrosis who need higher calorie and fat intake. Choice D is incorrect because while a high-protein diet is beneficial, a high-fiber diet may not be suitable for a child with cystic fibrosis due to potential gastrointestinal issues.

3. During an assessment, an infant is suspected to have intussusception. Which of the following findings should the nurse expect?

• A. Currant jelly stools
• B. Projectile vomiting
• C. Scaphoid abdomen
• D. Frequent stools

Correct answer: A

Rationale: Intussusception is a condition where one segment of the intestine telescopes into another, causing obstruction. The classic presentation includes currant jelly stools, which are a mixture of blood and mucus due to the sloughing of the intestinal mucosa. This finding is a result of the compromised blood supply to the affected area and is a key characteristic associated with intussusception.

4. Difficulties with eating, sleeping, playing, repetitive or difficult behaviors, and paying attention may all be caused in part by which of the following?

• A. Cognitive delays
• B. Lack of motivation for mastery
• C. Sensory processing challenges
• D. Imitation deficits

Correct answer: C

Rationale: Sensory processing challenges can affect various aspects of a child's daily life, including eating, sleeping, playing, behavior, and attention. These challenges can lead to difficulties in processing sensory information, which may manifest in different behaviors and impact their overall functioning.

5. When caring for a child with hyponatremia, a nurse delegates care to a licensed vocational nurse (LVN) and instructs the LVN to promptly report which clinical manifestation?

• A. Seizures
• B. Respiratory distress
• C. Hyperthermia
• D. Bradycardia

Correct answer: A

Rationale: Seizures are a significant concern in severe hyponatremia as they indicate potential neurological complications and the need for urgent intervention to prevent further harm to the child. Prompt reporting of seizures allows for timely assessment and appropriate treatment to ensure the child's safety and well-being.

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