Nursing Elites

1. The practical nurse is caring for a child who has just returned from surgery for an appendectomy. Which intervention should the nurse implement?

• A. Encourage early ambulation.
• B. Apply warm compresses to the incision site.
• C. Monitor for signs of infection at the surgical site.
• D. Provide a high-fiber diet immediately post-op.

Correct answer: C

Rationale: Monitoring for signs of infection at the surgical site is crucial after an appendectomy as it helps in early detection and treatment of any potential complications. This intervention is essential for ensuring the child's proper healing and recovery post-surgery. Encouraging early ambulation is generally beneficial post-operatively but may not be the priority immediately after an appendectomy. Applying warm compresses to the incision site may not be indicated as it can increase the risk of infection. Providing a high-fiber diet immediately post-op is not recommended as the digestive system needs time to recover from surgery.

2. What is the best response for a two-year-old boy who begins to cry when the mother starts to leave?

• A. Let's wave bye-bye to mommy.
• B. Two-year-olds usually stop crying the minute the parent leaves.
• C. Now be a big boy. Mommy will be back soon.
• D. Let's wave bye-bye to mommy.

Correct answer: D

Rationale: The best response for a two-year-old boy who begins to cry when the mother starts to leave is to wave bye-bye to mommy. This action helps the child understand that the separation is temporary and gives him a sense of closure. Choice A is the correct answer. Choice B is incorrect as it generalizes the behavior of two-year-olds. Choice C may invalidate the child's feelings by telling him to 'be a big boy' instead of acknowledging his emotions and providing comfort.

3. The nurse is caring for a 2-year-old child who was admitted for dehydration due to gastroenteritis. The child is now receiving IV fluids and appears more alert. What is the best indicator that the child’s condition is improving?

• A. The child is more alert and playful
• B. The child’s urine output has increased
• C. The child’s vital signs are stable
• D. The child is tolerating small amounts of oral fluids

Correct answer: B

Rationale: Increased urine output is a reliable indicator that hydration status is improving. While alertness and playfulness are positive signs, increased urine output directly reflects improved hydration. Stable vital signs are important but may not directly indicate hydration status. Tolerating small amounts of oral fluids is a good sign but may not be as direct an indicator as increased urine output.

4. During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing?

• A. Separation anxiety.
• B. Associative play.
• C. Object prehension.
• D. Object permanence.

Correct answer: D

Rationale: When a baby looks for a hidden object, it demonstrates the development of object permanence. This milestone is significant as it signifies the baby's understanding that objects continue to exist even when they are not visible. It is a crucial aspect of cognitive development in infancy. Choice A, separation anxiety, refers to distress when separated from a primary caregiver and is not demonstrated in this scenario. Choice B, associative play, involves interactive play with others and is not relevant to object search. Choice C, object prehension, refers to the ability to grasp and hold objects, which is not specifically demonstrated by looking for a hidden object in this context.

5. A child with cystic fibrosis is admitted to the hospital with respiratory distress. Which intervention should the practical nurse (PN) implement?

• A. Administer bronchodilators as prescribed.
• B. Limit fluid intake.
• C. Provide a high-fat diet.
• D. Encourage bed rest only.

Correct answer: A

Rationale: Administering bronchodilators as prescribed is crucial for managing respiratory distress in children with cystic fibrosis. Bronchodilators help to open the airways, facilitating easier breathing for the child. Limiting fluid intake, providing a high-fat diet, or encouraging bed rest only are not appropriate interventions for respiratory distress associated with cystic fibrosis. Limiting fluid intake could worsen dehydration, a high-fat diet is not recommended due to pancreatic insufficiency in cystic fibrosis, and bed rest alone does not address the respiratory distress.

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