Nursing Elites

1. The nurse is preparing to administer an intramuscular injection to a toddler-age client. Which is the most appropriate statement by the nurse prior to this procedure?

• A. "We will give you your shot when your mommy comes back."
• B. "I will wipe your skin with a magic wipe and then hold the needle like this and say one, two, three, go and give you your shot. Are you ready?"
• C. "It is all right to cry. After we are done, you can go to the box and pick out your favorite sticker."
• D. "This is a magic sword that will give you your medicine and make you all better."

Correct answer: C

Rationale: The correct answer is C because it acknowledges the child's feelings, provides clear instructions, and offers comfort and rewards to help the child cope with the procedure. Choice A is not appropriate as it may create anxiety about the injection. Choice B uses the term 'magic,' which may confuse the child and lead to fear. Choice D introduces a fantasy element that may not be beneficial in preparing the child for the injection.

2. What is the purpose of using cimetidine (Tagamet) for gastroesophageal reflux?

• A. The medication reduces gastric acid secretion.
• B. The medication neutralizes the acid in the stomach.
• C. The medication increases the rate of gastric emptying time.
• D. The medication coats the lining of the stomach and esophagus.

Correct answer: A

Rationale: The correct answer is A. Cimetidine (Tagamet) is an H2 receptor antagonist that works by reducing gastric acid secretion. This action helps to decrease the acidity in the stomach, which in turn reduces the symptoms of gastroesophageal reflux. Choice B is incorrect because cimetidine does not neutralize acid but rather decreases its production. Choice C is incorrect as cimetidine does not affect the rate of gastric emptying time. Choice D is incorrect as cimetidine does not coat the lining of the stomach and esophagus but instead works to reduce gastric acid secretion.

3. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine?

• A. The hepatitis B vaccination series should be begun at birth
• B. All are applicable
• C. Any child not vaccinated at birth should receive two doses at least 4 months apart
• D. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart

Correct answer: B

Rationale: Hepatitis B vaccination should start at birth, and any child or adolescent not vaccinated should complete the series. Adolescents should receive three doses if they were not previously vaccinated.

4. What is the most effective way to prevent the spread of hand, foot, and mouth disease in a daycare setting?

• A. Handwashing
• B. Isolating sick children
• C. Disinfecting toys
• D. Encouraging vaccination

Correct answer: A

Rationale: Handwashing is indeed the most effective way to prevent the spread of hand, foot, and mouth disease in children. Proper hand hygiene helps in removing and killing germs that can cause infections. While isolating sick children and disinfecting toys are important measures to prevent the spread of diseases, they are not as effective as handwashing. Encouraging vaccination, in this case, is not relevant since there is no specific vaccine available for hand, foot, and mouth disease.

5. What is a common sign of moderate dehydration in children?

• A. Dry mucous membranes
• B. Normal capillary refill
• C. Hyperactive bowel sounds
• D. Edema

Correct answer: A

Rationale: Dry mucous membranes are a common sign of moderate dehydration in children, indicating a loss of bodily fluids. When a child is moderately dehydrated, the mucous membranes in the mouth and nose may appear dry. This condition can occur due to various factors such as vomiting, diarrhea, or inadequate fluid intake. Normal capillary refill (choice B) is not typically associated with dehydration; it is a measure of circulatory status. Hyperactive bowel sounds (choice C) can be present in conditions like gastroenteritis but are not specific to dehydration. Edema (choice D) is the retention of fluid in the body and is not a typical sign of dehydration.

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