Nursing Elites

1. When teaching parents of a 5-year-old child with sickle cell anemia about pain management, what information should be included?

• A. Apply cold compresses to painful areas.
• B. Encourage the child to rest as much as possible.
• C. Administer prescribed pain medication at the first sign of pain.
• D. Offer a high-protein diet to help with pain management.

Correct answer: C

Rationale: Administering prescribed pain medication at the first sign of pain is crucial in managing sickle cell anemia-related pain effectively. Prompt administration helps prevent the pain from escalating and becoming severe, enhancing the child's comfort and quality of life. Cold compresses, rest, and diet modifications may play supportive roles but are not as directly impactful in addressing acute pain episodes associated with sickle cell anemia. Therefore, while comforting measures like cold compresses and rest are helpful, they should not replace the importance of timely administration of prescribed pain medication. Additionally, offering a high-protein diet, although important for overall health, is not directly linked to managing acute pain in sickle cell anemia.

2. The healthcare provider is providing postoperative care to a 7-year-old child who had surgery for appendicitis. The child is experiencing pain at the surgical site. What is the healthcare provider's priority action?

• A. Administer the prescribed pain medication
• B. Encourage the child to take deep breaths
• C. Apply a warm compress to the surgical site
• D. Reposition the child to a more comfortable position

Correct answer: A

Rationale: Administering the prescribed pain medication is crucial to effectively manage the child's postoperative pain. Pain management is a priority to ensure the child's comfort and promote healing following surgery. Encouraging deep breaths, applying warm compresses, or repositioning the child may help, but addressing the pain with medication is the initial and most vital intervention.

3. The mother of an 11-year-old boy with juvenile arthritis tells the nurse, 'I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting.' Which information is most important for the nurse to provide this mother?

• A. The child should be encouraged to rest when experiencing pain
• B. Encourage quiet activities such as reading as a pain distracter
• C. The use of hot baths can be used as an alternative to pain medication
• D. Giving pain medication around the clock helps control the pain

Correct answer: D

Rationale: It is crucial for the nurse to educate the mother that giving pain medication around the clock helps manage pain effectively and improves the child's quality of life. This approach ensures a more consistent level of pain relief and prevents the pain from becoming severe, which can be more challenging to manage. Choices A, B, and C do not address the importance of consistent pain management and may not provide adequate relief for the child's condition.

4. What information should be reinforced with the mother of a child with ringworm (Tinea)?

• A. Ringworm is not contagious.
• B. Tinea infections are indicative of poor hygiene and uncleanliness.
• C. Tinea infections are spread by direct and indirect contact.
• D. Ringworm often subsides spontaneously.

Correct answer: C

Rationale: The correct answer is C. Ringworm, a fungal infection, is highly contagious and can be spread by direct contact with infected individuals or animals and indirectly through contaminated objects. It is important for the mother to understand the modes of transmission to prevent the spread of the infection to others and to take necessary precautions to ensure proper treatment and containment of the condition. Choices A and D are incorrect because ringworm is indeed contagious, and it may not always subside spontaneously. Choice B is misleading as tinea infections are not solely indicative of poor hygiene; they can affect anyone, regardless of personal cleanliness.

5. A 3-year-old with HIV infection is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first?

• A. Remove the child who has HIV from the foster home.
• B. Report the exposure of the child with HIV to the health department.
• C. Place the child who has HIV in reverse isolation.
• D. Review the immunization documentation of the child who has HIV.

Correct answer: D

Rationale: The priority action for the nurse is to review the immunization documentation of the child with HIV to ensure they have received the necessary vaccines. This step is crucial in protecting the child's health and preventing further complications from vaccine-preventable diseases like pertussis. By reviewing the immunization documentation first, the nurse can determine the child's protection against pertussis and other infectious diseases. Removing the child from the foster home (Choice A) may not be necessary if the child is adequately vaccinated. Reporting the exposure to the health department (Choice B) and placing the child in reverse isolation (Choice C) are important steps but reviewing the immunization status takes precedence to assess the child's protection and guide further actions.

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