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 Choices A, B, and C are less likely because the child's emotional response is typically more subdued and withdrawn in such circumstances, rather than being cheerful, consistently sad, or excessively crying.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. A healthcare provider is educating a parent group about the importance of immunizations. Which disease can be prevented by the varicella vaccine?

• A. Measles
• B. Mumps
• C. Rubella
• D. Chickenpox

Correct answer: D

Rationale: The varicella vaccine is specifically designed to prevent chickenpox. Measles, mumps, and rubella are prevented by different vaccines: Measles is prevented by the measles, mumps, and rubella (MMR) vaccine; Mumps is prevented by the MMR vaccine; and Rubella is also prevented by the MMR vaccine. Therefore, the correct answer is D, Chickenpox, as it is the disease prevented by the varicella vaccine.

3. After completing 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 visit of a family member

Correct answer: B

Rationale: It is recommended that a child should visit the dentist within the next few months after turning two years old. This allows for early dental check-ups to monitor oral health, detect any issues early on, and establish a good oral hygiene routine. Choice A ('Before starting school') is not as specific and may delay the child's first dental visit. Choice C ('When the first deciduous teeth are lost') is too late for the first dental visit, as preventive care should start earlier. Choice D ('At the next dental visit of a family member') is not ideal as the child's dental needs should be addressed independently of family members' visits.

4. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include

• A. oxygen, uterine massage, and transport
• B. oxygen, placement on the left side, and transport
• C. oxygen, treatment for shock, and uterus massage during transport
• D. oxygen, internal vaginal pads, and treatment of shock during transport

Correct answer: C

Rationale: Postpartum hemorrhage can lead to shock due to excessive bleeding. Oxygen should be provided to support oxygenation. Treatment for shock, which includes maintaining vital signs and perfusion, is crucial. Uterine massage helps prevent further bleeding by promoting uterine contraction. This combination of interventions is essential for managing postpartum hemorrhage effectively. Choices A, B, and D lack the comprehensive approach needed for managing postpartum hemorrhage, as they do not address the treatment of shock, which is vital in this scenario.

5. When compensating for increased physical activity, what should the nurse teach a child with type 1 diabetes to do?

• A. Eat more food when planning to exercise more than usual.
• B. Take oral, not injectable insulin, on days of heavy exercise.
• C. Take insulin in the morning when extra exercise is anticipated.
• D. Eat foods that contain sugar to compensate for the extra exercise.

Correct answer: A

Rationale: The correct answer is to 'Eat more food when planning to exercise more than usual.' Increased physical activity requires more energy, so additional food intake is necessary to prevent hypoglycemia. Choice B is incorrect because the method of insulin administration should not be altered based on physical activity. Choice C is incorrect as insulin timing should be consistent rather than based on anticipated exercise. Choice D is incorrect since relying on foods with sugar can lead to unstable blood sugar levels, which is not ideal for managing diabetes during exercise.

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