Nursing Elites

1. Before starting kindergarten, the child should receive boosters of which primary immunizations to ensure ongoing protection?

• A. IPV, HepB, Td.
• B. DTaP, HepB, Td.
• C. MMR, DTaP, Hib.
• D. DTaP, IPV, MMR.

Correct answer: D

Rationale: Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR. DTaP provides protection against diphtheria, tetanus, and pertussis, IPV protects against polio, and MMR immunization covers measles, mumps, and rubella. These boosters are essential to maintain immunity and protect the child from these diseases as they enter school. Choices A, B, and C are incorrect because they do not include the recommended boosters for kindergarten entry and may leave the child susceptible to certain infections.

2. After a child has just returned from surgery for a tracheostomy, what is the priority nursing action?

• A. Suctioning the tracheostomy tube
• B. Changing the tracheostomy dressing
• C. Monitoring respiratory status
• D. Ensuring the tracheostomy ties are secure

Correct answer: A

Rationale: The priority nursing action after a child has undergone tracheostomy surgery is to suction the tracheostomy tube. Suctioning is crucial to maintain a clear airway, remove secretions, and prevent potential airway obstruction, which is essential for the child's respiratory function. Changing the tracheostomy dressing, while important for wound care, does not take precedence over airway clearance. Monitoring respiratory status is vital but comes after ensuring airway patency. Ensuring tracheostomy ties are secure is significant for stabilizing the tube but is not as urgent as maintaining a patent airway through suctioning.

3. A 5-year-old child is diagnosed with acute glomerulonephritis. What is a key assessment the nurse should perform?

• A. Monitor blood glucose levels
• B. Monitor respiratory rate
• C. Monitor urine output
• D. Monitor for signs of infection

Correct answer: C

Rationale: In a child diagnosed with acute glomerulonephritis, monitoring urine output is a crucial assessment. Acute glomerulonephritis affects the kidneys, leading to decreased urine output due to impaired kidney function. Monitoring urine output helps assess renal perfusion, fluid status, and kidney function. This assessment is essential in determining the effectiveness of treatment and identifying complications. Monitoring blood glucose levels (Choice A) is not directly related to acute glomerulonephritis. Respiratory rate (Choice B) may be important in other conditions but is not a key assessment for acute glomerulonephritis. Monitoring for signs of infection (Choice D) is important in general, but it is not specific to the primary issue of impaired kidney function in acute glomerulonephritis.

4. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?

• A. Monitoring for signs of infection
• B. Providing nutritional support
• C. Monitoring for signs of bleeding
• D. Monitoring for signs of pain

Correct answer: A

Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.

5. A nurse is assessing a child with suspected rotavirus infection. What clinical manifestation is the nurse likely to observe?

• A. Abdominal pain
• B. Diarrhea
• C. Constipation
• D. Vomiting

Correct answer: B

Rationale: The correct answer is B: Diarrhea. Rotavirus infection commonly presents with symptoms such as watery diarrhea, vomiting, fever, and abdominal pain. While abdominal pain and vomiting are also associated with rotavirus infection, diarrhea is a hallmark feature. Constipation is not typically seen in cases of rotavirus infection. Therefore, the most likely clinical manifestation that the nurse would observe in a child with suspected rotavirus infection is diarrhea.

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