Nursing Elites

1. What behavior does a toddler subjected to prolonged hospitalization with limited parental visits typically exhibit?

• A. Engage in cheerful interactions with staff members
• B. Display indications of sadness throughout the day
• C. Experience excessive crying when parents are not present
• D. Show limited emotional response to the environment

Correct answer: D

Rationale: Toddlers subjected to prolonged hospitalization with limited parental visits usually exhibit a limited emotional response to the environment. This behavior can be a coping mechanism for the child in dealing with the separation from their primary caregivers. The child might not show the same level of engagement or emotional expression as they would if their parents were present. Choices A, B, and C are less likely because the child's emotional response is typically more subdued and withdrawn in such circumstances, rather than being cheerful, consistently sad, or excessively crying.

2. The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury?

• A. Recommend raising the bed's side rails throughout the day and night.
• B. Suggest having a caregiver present continuously to prevent falls from bed.
• C. Encourage the use of a loose restraint when he is in bed.
• D. Recommend raising the bed's side rails when a caregiver is not present.

Correct answer: D

Rationale: For a child with muscular dystrophy who fell out of bed, it is important to prevent further injuries. Using bed side rails when a caregiver is not present can help provide a safety measure and prevent falls. While continuous caregiver presence (choice B) may be ideal, it may not always be feasible. Recommending raising the bed's side rails throughout the day and night (choice A) may limit the child's mobility unnecessarily. Encouraging the use of a loose restraint (choice C) can be dangerous and may increase the risk of injury in case of a fall.

3. What should be taught to the child and parents about using a peak flow meter for a child diagnosed with asthma?

• A. Use the device before taking medication
• B. Use the device during asthma attacks
• C. Record the best of three attempts
• D. Use the device after eating

Correct answer: C

Rationale: The correct answer is to 'Record the best of three attempts.' This method provides an accurate measure of peak expiratory flow using a peak flow meter. By taking the best of three attempts, the child and parents can obtain a more reliable assessment of the child's lung function. Choices A, B, and D are incorrect because using the device before taking medication, during asthma attacks, or after eating does not ensure an accurate measurement of peak flow, which is essential for managing asthma effectively. Monitoring peak flow regularly and accurately can help in adjusting asthma treatment plans and assessing response to medications.

4. Which best describes a full-thickness (third-degree) burn?

• A. Erythema and pain
• B. Skin showing erythema followed by blister formation
• C. Destruction of all layers of skin evident with extension into subcutaneous tissue
• D. Destruction injury involving underlying structures such as muscle, fascia, and bone

Correct answer: C

Rationale: The correct answer is C: Full-thickness burns involve the destruction of all layers of skin, extending into the subcutaneous tissue. This type of burn causes severe damage and loss of sensation due to nerve destruction. Choice A, erythema and pain, describes superficial burns (first-degree). Choice B, skin showing erythema followed by blister formation, describes partial-thickness burns (second-degree). Choice D, destruction injury involving underlying structures such as muscle, fascia, and bone, goes beyond the description of full-thickness burns.

5. The parents of a newborn with phenylketonuria (PKU) need help and support in adhering to specific dietary restrictions. They ask the nurse, “How long will our child have to be on this diet?” How should the nurse respond?

• A. “We are still not sure; you should discuss this with your health care provider.”
• B. “If your baby does well, foods containing protein can gradually be introduced.”
• C. “Your child needs to be on this diet at least through adolescence and into adulthood.”
• D. “This is a lifelong problem, and it is recommended that dietary restrictions must be continued.”

Correct answer: D

Rationale: The correct answer is D: “This is a lifelong problem, and it is recommended that dietary restrictions must be continued.” PKU requires a lifelong adherence to a specific diet low in phenylalanine to prevent cognitive and developmental issues. Phenylalanine buildup can lead to irreversible damage, making it crucial for individuals with PKU to maintain dietary restrictions throughout their lives. Choices A, B, and C are incorrect because they do not address the lifelong nature of dietary restrictions necessary for PKU management.

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