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. Before administering a tube feeding to a child, what should the practical nurse (PN) assess?

• A. Tube placement.
• B. Bowel sounds.
• C. Abdominal circumference.
• D. Tube patency.

Correct answer: A

Rationale: Assessing tube placement is critical before initiating a tube feeding to verify its correct positioning in the stomach. This assessment helps prevent potential complications such as aspiration if the tube is incorrectly placed in the respiratory tract. Checking bowel sounds, abdominal circumference, and tube patency are important assessments in the care of a child receiving tube feedings, but ensuring proper tube placement takes precedence to ensure safe and effective delivery of nutrition.

3. The practical nurse is caring for a child who was admitted for treatment of seizures. Which intervention should the nurse implement to help prevent injury from a seizure?

• A. Have a padded tongue depressor at the bedside.
• B. Keep the side rails padded and in an upright position.
• C. Place a padded helmet on the child’s head.
• D. Restrain the child during the seizure activity.

Correct answer: B

Rationale: The correct intervention to help prevent injury during a seizure is to keep the side rails padded and in an upright position. This measure helps to ensure the child's safety by preventing falls or accidental injuries. Using a padded tongue depressor or restraining the child can potentially cause harm and are not recommended. Placing a padded helmet is not a standard intervention for seizure safety in this scenario.

4. What is the recommended analgesia for preparing a school-age child for a lumbar puncture (LP)?

• A. Ondansetron (Zofran) 4 mg / 5 ml PO TID.
• B. Codeine 10 mg PO 30 minutes before the procedure.
• C. A transdermal fentanyl (Duragesic) patch immediately before the procedure.
• D. EMLA (eutectic mixtures of local anesthetics) 2.5 hours before the procedure.

Correct answer: D

Rationale: For a lumbar puncture in a school-age child, EMLA cream should be applied 2.5 hours before the procedure. EMLA is commonly used to numb the skin, reducing pain and discomfort for the child during the procedure. Choices A, B, and C are incorrect because ondansetron is an antiemetic, codeine is an opioid analgesic that may not be suitable for children, and transdermal fentanyl is a strong opioid that is not typically used for local anesthesia in children undergoing lumbar puncture.

5. When assessing a 10-year-old newly diagnosed with osteomyelitis, which information is most important for the nurse to obtain?

• A. Recent history of infection recurrences.
• B. Cultural heritage and beliefs.
• C. Family history of bone disorders.
• D. Increased fluid intake occurrences.

Correct answer: A

Rationale: In a 10-year-old with newly diagnosed osteomyelitis, the most important information for the nurse to obtain is the recent history of infection recurrences. This is crucial because osteomyelitis is an infection of the bone, and assessing for any recent recurrence of infections can help in determining the possible source of the osteomyelitis and guide the treatment plan accordingly. Choices B, C, and D are less relevant in the immediate assessment of a newly diagnosed case of osteomyelitis as they do not directly impact the current infection or treatment plan.

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