Nursing Elites

1. The caregiver is being educated by a healthcare provider about the use of a metered-dose inhaler (MDI) for their 8-year-old child with asthma. Which statement by the caregiver indicates a need for further teaching?

• A. I will shake the inhaler before each use
• B. My child should breathe in quickly after pressing the inhaler
• C. I should wait a minute between puffs
• D. We should use a spacer with the inhaler

Correct answer: B

Rationale: The caregiver should be informed that the child should breathe in slowly and deeply after pressing the inhaler. This allows for better medication delivery to the lungs and ensures optimal effectiveness of the treatment.

2. While teaching a parenting class to new parents, the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors?

• A. Children need help in developing social skills.
• B. This age group fears loss of self-control.
• C. They provide the child with a sense of security.
• D. Children must learn to deal with authority.

Correct answer: C

Rationale: Implementing discipline and limit setting for infants and toddlers is primarily important as it provides them with a sense of security. This sense of security is crucial for their emotional and psychological development, helping them feel safe and supported as they explore the world around them. Choice A is incorrect because while developing social skills is important, the primary reason for discipline and limit setting in this context is to provide security. Choice B is incorrect as it does not address the main reason for implementing discipline and limit setting. Choice D is incorrect as the primary focus is not about dealing with authority at this early stage of development.

3. The mother of a 14-year-old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide?

• A. I will ask the HCP for a psychiatric consult for your child
• B. This type of acting out behavior is normal for adolescents
• C. It is important to focus on your child's needs at this difficult time
• D. A reaction of anger is your child's attempt to cope with this loss

Correct answer: D

Rationale: Acknowledging the child's anger as a coping mechanism helps validate their feelings and can open a dialogue for further support.

4. A 6 year old who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a 35% of personal best peak expiratory flow rate (PEFR). Based on these findings, what actions should the nurse take first?

• A. Administer a prescribed bronchodilator.
• B. Encourage the child to cough and deep breath.
• C. Report findings to the health care provider.
• D. Determine what triggers precipitated this attack.

Correct answer: A

Rationale: Administering a bronchodilator will help open the airways and improve breathing.

5. A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child’s plan of care?

• A. Obtain vital signs to monitor for fluid overload
• B. Change IV site dressing every 3 days and as needed
• C. Monitor for signs of facial swelling or urticaria
• D. Assess for abdominal pain and vomiting

Correct answer: C

Rationale: Monitoring for signs of an allergic reaction, such as facial swelling or urticaria, is crucial when administering antibiotics like azithromycin. It is important to watch for these signs to promptly identify and manage any potential adverse reactions during the course of treatment.

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