Nursing Elites

1. Why is the infant scheduled to receive the intramuscular polio vaccine instead of the oral vaccine, as asked by the parents?

• A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
• B. Both vaccines produce the same results and are equally safe, according to consensus.
• C. The intramuscular vaccine is preferred over the oral vaccine due to cost considerations, unless contraindicated.
• D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.

Correct answer: A

Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine over the oral vaccine due to its superior safety profile. Intramuscular administration ensures better immunogenicity and protection against poliovirus. Choice B is incorrect as the intramuscular vaccine is preferred for safety reasons. Choice C is incorrect because the recommendation is based on safety, not cost. Choice D is incorrect as the CDC recommendation is not solely based on immunocompromised status but rather on the overall safety and efficacy of the vaccine.

2. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?

• A. Dislocated radial head
• B. Transient synovitis of the hip
• C. Osgood-Schlatter disease
• D. Scoliosis

Correct answer: C

Rationale: Osgood-Schlatter disease is a common overuse injury that specifically affects the knee. It is characterized by inflammation of the patellar ligament at the tibial tuberosity due to repetitive strain on the growth plate during activities such as running and jumping. Dislocated radial head (Choice A) is not an overuse disorder but rather an injury usually seen in young children. Transient synovitis of the hip (Choice B) is an acute hip condition and not typically classified as an overuse disorder. Scoliosis (Choice D) is a condition characterized by an abnormal lateral curvature of the spine and is not considered an overuse disorder.

3. What is the priority nursing intervention for a child with a diagnosis of acute lymphoblastic leukemia (ALL) receiving chemotherapy?

• A. Preventing infection
• B. Administering chemotherapy
• C. Providing nutritional support
• D. Monitoring fluid intake

Correct answer: A

Rationale: The correct answer is A: Preventing infection. When caring for a child with acute lymphoblastic leukemia (ALL) undergoing chemotherapy, the top priority is to prevent infection. Chemotherapy suppresses the immune system, making the child more susceptible to infections. By implementing infection control measures such as hand hygiene, aseptic techniques, and environmental cleanliness, the nurse can help protect the child from potentially life-threatening infections. Administering chemotherapy (choice B) is important but not the priority over preventing infection. Providing nutritional support (choice C) and monitoring fluid intake (choice D) are essential aspects of care but take a back seat to preventing infection in this scenario.

4. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

• A. The child has a maculopapular rash on his palms.
• B. The parents report that their son is vomiting and not eating well.
• C. The parents report that their son is irritable and not gaining weight.
• D. Auscultation reveals wheezing with diminished lung sounds.

Correct answer: B

Rationale: Vomiting and poor appetite can be symptoms of neuroblastoma, a malignancy that affects the adrenal glands and sympathetic nervous system. A maculopapular rash on the palms (Choice A) is not typically associated with neuroblastoma. Irritability and poor weight gain (Choice C) may be non-specific findings and do not specifically point towards neuroblastoma. Auscultation findings of wheezing with diminished lung sounds (Choice D) are more indicative of respiratory conditions rather than neuroblastoma.

5. A child with a diagnosis of acute glomerulonephritis is admitted to the hospital. What is the priority nursing intervention?

• A. Monitoring for hypertension
• B. Providing pain relief
• C. Restricting fluid intake
• D. Encouraging fluid intake

Correct answer: A

Rationale: The correct answer is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, potentially leading to impaired kidney function and elevated blood pressure. Monitoring for hypertension is crucial as it is a common complication of this condition. Providing pain relief (choice B) may be necessary for comfort but is not the priority. While fluid restriction (choice C) is important in some kidney conditions, in acute glomerulonephritis, maintaining adequate hydration to support kidney function is typically recommended. Encouraging fluid intake (choice D) may exacerbate fluid overload, making it an inappropriate intervention in this scenario.

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