Nursing Elites

1. 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: The correct answer is C: Osgood-Schlatter disease. This condition is a common overuse injury that affects the knee. Osgood-Schlatter disease typically occurs in children and adolescents who are involved in activities that require frequent running, jumping, and kicking. It is characterized by pain, swelling, and tenderness at the tibial tuberosity, where the patellar tendon inserts into the tibia. Choice A, Dislocated radial head, is not an overuse disorder but rather a form of elbow injury where the head of the radius bone is displaced from its normal position. Choice B, Transient synovitis of the hip, is a self-limiting condition that causes hip pain and limping in children. It is not typically considered an overuse disorder. Choice D, Scoliosis, is a condition characterized by an abnormal lateral curvature of the spine. While it may be related to certain activities or postures, it is not primarily classified as an overuse disorder.

2. A parent calls the clinic because their child has ingested a small amount of household bleach. What should the nurse advise?

• A. Administer activated charcoal
• B. Induce vomiting immediately
• C. Call the poison control center
• D. Take the child to the emergency department

Correct answer: C

Rationale: In the case of a child ingesting household bleach, the primary advice should be to call the poison control center (Choice C). The poison control center can provide specific guidance on how to manage the ingestion, including whether any immediate interventions are necessary. Administering activated charcoal (Choice A) or inducing vomiting immediately (Choice B) can worsen the situation as they are not recommended treatments for bleach ingestion. Taking the child to the emergency department (Choice D) may be necessary depending on the advice given by the poison control center, but the initial step should be to seek guidance from the experts at the poison control center.

3. After the nurse has completed an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?

• A. Before starting school
• B. Within the next few months
• C. When the first deciduous teeth are lost
• D. At the next dental check-up for a family member

Correct answer: B

Rationale: The most appropriate time for a child to first visit the dentist is within the next few months after turning two years old. This visit allows the dentist to assess the child's oral health, provide guidance on proper oral hygiene practices, and establish a positive relationship with dental care. Choice A (Before starting school) is not as specific and timely as the recommended age of 2 years. Choice C (When the first deciduous teeth are lost) is not ideal as preventive dental visits should start earlier to establish good oral health habits. Choice D (At the next dental check-up for a family member) may delay the child's first dental visit, missing the opportunity for early preventive care and guidance.

4. After a child returns from surgery for a tracheostomy, what is the priority nursing action?

• A. Suctioning the tracheostomy tube
• B. Changing the tracheostomy dressing
• C. Monitoring respiratory status
• D. Ensuring the tracheostomy ties are secure

Correct answer: A

Rationale: The priority nursing action after a tracheostomy surgery is to suction the tracheostomy tube. Suctioning helps maintain a clear airway and prevent complications such as airway obstruction or respiratory distress. While monitoring respiratory status is important, suctioning takes precedence immediately post-surgery to ensure adequate air exchange. Changing the tracheostomy dressing and ensuring tracheostomy ties are secure are also essential tasks but are secondary to the critical need for airway maintenance through suctioning.

5. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?

• A. They will increase tidal volumes.
• B. Drainage of air and fluid will be facilitated.
• C. They will maintain positive intrapleural pressure.
• D. Pressure on the pericardium and chest wall will be regulated.

Correct answer: B

Rationale: Chest tubes are necessary after open-heart surgery to facilitate the drainage of air and fluid from the chest cavity. These tubes help prevent complications such as pneumothorax (accumulation of air in the pleural space) or cardiac tamponade (build-up of fluid in the pericardial sac), which can be serious postoperative issues. Options A, C, and D are incorrect because chest tubes are primarily used for draining purposes and not for increasing tidal volumes, maintaining positive intrapleural pressure, or regulating pressure on the pericardium and chest wall.

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