Nursing Elites

1. The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?

• A. Inform toddlers about an upcoming procedure 2 hours before the procedure is to be performed.
• B. Inform school-age children about an upcoming procedure immediately before the procedure is scheduled to occur.
• C. Discourage parent presence during procedures on infants and toddlers.
• D. Use simple diagrams of anatomy and physiology to explain a procedure to a school-age child.

Correct answer: D

Rationale: Using simple diagrams helps school-age children understand what to expect in a procedure, catering to their developmental level and reducing anxiety. Informing toddlers too early can increase anxiety, and parents' presence is generally comforting, not discouraging.

2. The nurse is planning an educational session for a group of 9-year-olds and their parents aimed at decreasing injuries and accidents among this age group. Which topics should be included in the educational session to accomplish the goal?

• A. Safety rules when dealing with fire to prevent burns.
• B. Safety rules when dealing with toxic substances to prevent poisonings.
• C. Pedestrian, motor vehicle, and bike safety rules.
• D. Safety information regarding the use of all-terrain vehicles (ATVs).

Correct answer: C

Rationale: For school-aged children, pedestrian, motor vehicle, and bike safety are critical areas to focus on as accidents involving these are common in this age group. Education about fire safety and toxic substances is also important, but the priority is on preventing accidents in everyday activities. Therefore, choices A, B, and D are not the most relevant for addressing the goal of decreasing injuries and accidents in this age group.

3. The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child’s pain?

• A. Give only an opioid analgesic at this time.
• B. Increase the dosage of analgesic until the child is adequately sedated.
• C. Plan a preventive schedule of pain medication around the clock.
• D. Give the child a clock and explain when they can have pain medications.

Correct answer: C

Rationale: For severe postoperative pain, a preventive around-the-clock schedule is necessary to prevent decreased plasma levels of medications. Providing only an opioid analgesic at this time may not be sufficient for effective pain management. Increasing the dosage without an order is unsafe and may lead to oversedation. Planning a preventive schedule of pain medication around the clock ensures consistent pain relief and better management. Giving the child a clock and explaining when they can have pain medications may increase the child's focus on waiting for relief rather than addressing the pain promptly, making it a less effective strategy.

4. What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls?

• A. Avoid public toilet facilities
• B. Limit long baths as much as possible
• C. Cleanse the perineum with water after voiding
• D. Ensure clear liquid intake of 2 L/day

Correct answer: C

Rationale: Proper perineal hygiene, including cleansing with water after voiding, is crucial in preventing UTIs in young girls. Avoiding public toilets and limiting baths are less effective than proper hygiene practices.

5. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

• A. Purposeful and goal-directed
• B. A simple developmental process
• C. Based on deliberate and irrational thought
• D. Assists individuals in guessing what is most appropriate

Correct answer: A

Rationale: Clinical reasoning is purposeful and goal-directed, involving the use of critical thinking and decision-making skills to provide effective patient care.

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