Nursing Elites

1. The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

• A. Passive range-of-motion exercises to promote hip flexion
• B. Oxygen at 2 L nasal cannula to maintain saturation above 95%
• C. Hourly vital signs and neurologic checks
• D. Elevate head of bed 30 degrees

Correct answer: A

Rationale: In a pediatric client with increased intracranial pressure (ICP) and decreased level of consciousness (LOC), passive range-of-motion exercises to promote hip flexion should be questioned as they can potentially increase intracranial pressure. This action may not be safe for the client's condition. The other options are appropriate interventions for managing a pediatric client with increased ICP and decreased LOC.

2. A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?

• A. Spinal cord injury
• B. Increased intracranial pressure
• C. Typical for sleep
• D. Improvement

Correct answer: B

Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.

3. A nurse is caring for a child who has a new diagnosis of osteomyelitis. Which of the following actions should the nurse take?

• A. Administer aspirin for pain.
• B. Apply ice to the affected area.
• C. Monitor the child�s weight daily.
• D. Limit the child's activity.

Correct answer: C

Rationale: The nurse should monitor the child�s weight daily to assess the effectiveness of treatment for osteomyelitis and detect potential complications.

4. A parent of a child with attention deficit hyperactivity disorder (ADHD) is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Administer methylphenidate at bedtime.
• B. Increase stimuli in the child's environment.
• C. Administer an extra dose of medication if the child is overactive.
• D. Maintain a consistent bedtime routine.

Correct answer: D

Rationale: Maintaining a consistent bedtime routine is essential for children with ADHD as it helps in managing their symptoms effectively. Consistency in bedtime routines aids in regulating the child's sleep patterns, promoting better rest, and ultimately improving their behavior and focus during the day.

5. When evaluating infants and young children in early intervention services, which of the following is recommended?

• A. Gain information from family, caregivers, professionals, and the child to create a total picture of the child's strengths and challenges
• B. Report test scores and therapist observations rather than parent reports
• C. Identify the areas of concern, weaknesses, and deficits to best address the child's and family's needs
• D. Observe the child in one setting with objective data from professionals

Correct answer: A

Rationale: When evaluating infants and young children in early intervention services, it is crucial to gather information from multiple sources, including family, caregivers, professionals, and the child. This holistic approach helps create a comprehensive understanding of the child's strengths and challenges, leading to a more effective intervention plan.

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