Nursing Elites

1. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?

• A. “Attempt to distract the child by offering a toy to the child.”
• B. “Say nothing and allow the tantrum to continue until it ends.”
• C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
• D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”

Correct answer: B

Rationale: The nurse's best response is to allow the tantrum to continue until it ends without giving in to the child's demands. By not rewarding the child with the desired item during a tantrum, the child learns that this behavior is not effective in getting what they want. Offering a toy to distract the child (Choice A) may reinforce the idea that tantrums lead to rewards. Leaving the child with a babysitter (Choice C) does not address the issue at hand, which is teaching the child appropriate behavior in public places. Giving the child the item temporarily (Choice D) may encourage the child to have tantrums in the future to obtain desired items.

2. A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occurred. Which response by the nurse would be most appropriate?

• A. This condition is due to a genetic defect in the bones.
• B. It's most likely from how the baby was positioned in utero.
• C. They really don't know what causes this condition.
• D. There is probably an underlying deformity of the baby's hip.

Correct answer: B

Rationale: Metatarsus adductus is a condition where the front part of the foot is turned inward. It is often caused by the baby's position in the womb, leading to pressure on the foot during fetal development. Choice A is incorrect as metatarsus adductus is not primarily caused by a genetic defect in the bones. Choice C is incorrect as the cause of metatarsus adductus is known to be related to intrauterine positioning. Choice D is incorrect as metatarsus adductus specifically pertains to the foot and not the hip.

3. A child with a diagnosis of sickle cell anemia is experiencing a vaso-occlusive crisis. What is the most important nursing intervention?

• A. Administering oxygen
• B. Administering pain medication
• C. Monitoring fluid intake
• D. Encouraging physical activity

Correct answer: B

Rationale: Administering pain medication is the most crucial nursing intervention during a vaso-occlusive crisis in sickle cell anemia. Pain management is a priority to alleviate the patient's discomfort and improve outcomes. Administering oxygen may be necessary in some cases but is not the primary intervention for vaso-occlusive crisis. Monitoring fluid intake is important in sickle cell anemia but is not the priority during a crisis situation. Encouraging physical activity is contraindicated during a vaso-occlusive crisis as it can exacerbate pain and complications.

4. A 5-year-old child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?

• A. Assess the child's sleep patterns
• B. Assess the child's dietary intake
• C. Assess the child's academic performance
• D. Assess the child's behavior at home

Correct answer: B

Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger symptoms or exacerbate the condition. Monitoring the child's diet can help identify triggers, ensure proper nutrition, and support the child's overall health. Assessing sleep patterns (Choice A) may be relevant but is not as directly linked to asthma management as dietary intake. Academic performance (Choice C) and behavior at home (Choice D) are important aspects of a child's well-being but are not directly related to asthma management.

5. An infant is admitted to the neonatal intensive care unit (NICU) with exstrophy of the bladder. What covering should the nurse use to protect the exposed area?

• A. Loose diaper
• B. Dry gauze dressing
• C. Moist sterile dressing
• D. Petroleum jelly gauze pad

Correct answer: C

Rationale: In cases of exstrophy of the bladder, a moist sterile dressing is the most appropriate choice to protect the exposed bladder tissue. Moist sterile dressings help maintain a clean environment, prevent infection, and promote healing. A loose diaper (Choice A) may not provide adequate protection and may lead to contamination. Dry gauze dressing (Choice B) could adhere to the wound and cause trauma upon removal. Petroleum jelly gauze pad (Choice D) is not ideal as it may not provide the necessary barrier against infection and could potentially cause irritation.

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