Nursing Elites

1. What information should be reinforced with the parents of a school-aged child about Reye's syndrome?

• A. Vaccinate your child before the age of 7 against Reye's syndrome.
• B. Keep the child at home for 2 days after the symptoms appear.
• C. Avoid giving any medication containing aspirin during a viral illness.
• D. Do not provide any citrus juices during a bacterial or viral illness.

Correct answer: C

Rationale: The correct answer is C: 'Avoid giving any medication containing aspirin during a viral illness.' It is crucial to advise parents to avoid giving any medication containing aspirin during a viral illness to prevent Reye's syndrome. Reye's syndrome is a rare but serious condition linked to the use of aspirin during viral illnesses in children and teenagers. Choices A, B, and D are incorrect because vaccinating against Reye's syndrome is not applicable as there is no specific vaccine for it, keeping the child at home for 2 days after symptoms appear is not a preventive measure for Reye's syndrome, and avoiding citrus juices is not directly related to the prevention of Reye's syndrome.

2. The practical nurse (PN) is caring for an adolescent who has been diagnosed with mononucleosis. Which activity should the PN advise the adolescent to avoid?

• A. Playing video games.
• B. Drinking caffeinated beverages.
• C. Participating in contact sports.
• D. Eating spicy foods.

Correct answer: C

Rationale: Contact sports should be avoided in mononucleosis due to the risk of spleen rupture, which is a serious complication of the disease. The spleen can enlarge in mononucleosis, making it more susceptible to injury from contact sports, potentially leading to a life-threatening situation if rupture occurs.

3. The healthcare provider is evaluating the effects of thyroid therapy used to treat a 5-month-old with hypothyroidism. Which behavior indicates that the treatment has been effective?

• A. Laughs readily, turns from back to side.
• B. Has strong Moro and tonic neck reflexes.
• C. Keeps fists clenched, opens hands when grasping an object.
• D. Can lift head but not chest when lying on abdomen.

Correct answer: A

Rationale: In infants, laughing readily and turning from back to side are developmental milestones that indicate effective thyroid therapy and normal development. These actions demonstrate improved muscle tone, coordination, and overall growth, which are key indicators of successful treatment for hypothyroidism in infants. Choices B, C, and D describe behaviors that are not specific indicators of thyroid therapy effectiveness in treating hypothyroidism in infants.

4. In a 6-year-old child with asthma experiencing difficulty breathing and using accessory muscles to breathe with a peak flow reading in the red zone, what should the nurse do first?

• A. Administer a nebulized bronchodilator
• B. Obtain an arterial blood gas
• C. Start the child on oxygen therapy
• D. Contact the healthcare provider

Correct answer: A

Rationale: The correct action for a 6-year-old child with asthma who is experiencing difficulty breathing, using accessory muscles to breathe, and has a peak flow reading in the red zone is to administer a nebulized bronchodilator first. Nebulized bronchodilators work rapidly to open up the airways, providing immediate relief and improving breathing. This intervention is crucial in addressing the acute respiratory distress the child is facing. Obtaining an arterial blood gas, starting oxygen therapy, or contacting the healthcare provider can be considered after the initial administration of the bronchodilator, as they are not the primary interventions needed to manage the child's acute respiratory distress.

5. The parents of a 5-year-old child, recently diagnosed with celiac disease, are being educated by the healthcare provider. Which statement by the parents indicates a need for further teaching?

• A. We need to avoid giving our child any foods that contain wheat, barley, or rye
• B. Our child can still eat oats as long as they are labeled gluten-free
• C. We should read food labels carefully to check for hidden sources of gluten
• D. It’s okay for our child to have small amounts of gluten occasionally

Correct answer: D

Rationale: The correct answer is D. Children with celiac disease must strictly adhere to a gluten-free diet. Even small amounts of gluten can cause harm by triggering an immune response that damages the intestines. It is crucial for parents to understand that allowing their child to have small amounts of gluten occasionally is not safe and can lead to complications. Therefore, further teaching is needed to emphasize the importance of complete avoidance of gluten-containing foods for a child with celiac disease. Choices A, B, and C demonstrate understanding of the need to avoid gluten-containing foods and hidden sources of gluten, which are essential in managing celiac disease. Choice D is incorrect as it suggests a lax approach to the child's diet, which can be harmful in the case of celiac disease.

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