Nursing Elites

1. When instilling ear drops in a 2-year-old child, how should the practical nurse (PN) position the earlobe to straighten the external auditory canal?

• A. Up and back.
• B. Down and back.
• C. Up and forward.
• D. Down and forward.

Correct answer: B

Rationale: When administering ear drops to a child under three years old, it is essential to pull the earlobe down and back. This positioning helps straighten the external auditory canal, facilitating the proper administration of the ear drops. Pulling the earlobe down and back in young children aims to ensure that the medication reaches the intended area for optimal effectiveness.

2. What response should the practical nurse (PN) provide when a school-age child asks to talk with a dying sister?

• A. Talk loudly to ensure the dying person hears and recognizes others' voices.
• B. Touch can provide a tactile presence if the dying person does not respond to words.
• C. Sitting close offers the dying person the sensation of others' presence.
• D. Although the dying person may not respond, they can still hear what is said.

Correct answer: D

Rationale: The correct response is D because it is believed that hearing is the last sense to go. Even if the dying person does not respond, speaking to them can still provide comfort. Choice A is incorrect because talking loudly is not necessary and can be distressing. Choice B is incorrect as it focuses on touch rather than the sense of hearing. Choice C is incorrect because sitting close may not necessarily help the dying person hear better.

3. During a well-baby exam, a nurse finds that a 2-month-old's right testicle is not descended into the scrotum, but the left one is palpable. What should the nurse do?

• A. Ask if the right testis has been seen in the scrotum before
• B. Address potential concerns about future fertility
• C. Schedule an ultrasound to confirm the position of the testicle
• D. Prepare to obtain a urine specimen for culture

Correct answer: A

Rationale: The correct answer is to ask if the right testis has been seen in the scrotum before. The initial step in managing an undescended testicle is to determine if it has been previously observed in the scrotum or if this is a new finding. This information is crucial in deciding the next course of action. Choice B is incorrect because addressing future fertility concerns comes after confirming the status of the testicle. Choice C is unnecessary at this stage as the first step is to gather more history. Choice D is unrelated to the issue described and is not indicated in this scenario.

4. 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.

5. After observing a mother giving her 11-month-old ferrous sulfate followed by two ounces of orange juice, what should the nurse do next?

• A. Suggest placing the iron drops in the orange juice and feed the infant.
• B. Advise the mother to follow the iron drops with formula instead of orange juice.
• C. Instruct the mother to feed the infant nothing in the next 30 minutes after the iron.
• D. Give positive feedback about the way she administered the sulfate.

Correct answer: D

Rationale: Providing positive feedback is essential in reinforcing correct behaviors. By praising the mother for properly administering the ferrous sulfate to her 11-month-old, the nurse can encourage her to continue following the correct procedure. This positive reinforcement can boost the mother's confidence and adherence to the recommended administration method, ultimately benefiting the infant's health.

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