Nursing Elites

1. What is the major cause of death for children older than 1 year in the United States?

• A. Heart disease
• B. Childhood cancer
• C. Unintentional injuries
• D. Congenital anomalies

Correct answer: C

Rationale: Unintentional injuries are the leading cause of death among children older than 1 year in the United States.

2. The nurse determines that a child's intravenous infusion has infiltrated. The infused solution is a vesicant. What is the most appropriate nursing action?

• A. Stop the infusion and apply ice.
• B. End the infusion and notify the practitioner.
• C. Slow the infusion rate and notify the practitioner.
• D. Discontinue the infusion and apply warm compresses.

Correct answer: B

Rationale: If a vesicant solution infiltrates, stopping the infusion immediately and notifying the practitioner is critical to prevent tissue damage. Cold or warm compresses should only be applied following specific medical advice based on the vesicant involved.

3. The nurse is selecting a site to begin an intravenous infusion on a 2-year-old child. The superficial veins on his hand and arm are not readily visible. What intervention should increase the visibility of these veins?

• A. Gently tap over the site.
• B. Apply a cold compress to the site.
• C. Raise the extremity above the level of the body
• D. Use a rubber band as a tourniquet for 5 minutes.

Correct answer: A

Rationale: Gently tapping over the site helps dilate the veins and increase visibility. Applying a cold compress or raising the extremity above the body level constricts the veins, making them harder to access. Prolonged tourniquet use can cause discomfort and venous congestion.

4. A mother reports to the nurse that her 6-year-old child is highly active, irritable, irregular in habits, and adapts slowly to new routines, people, or situations. Which pattern of temperament would best describe the child?

• A. The 'easy' child
• B. The 'difficult' child
• C. The 'slow-to-warm-up' child
• D. The 'fast-to-warm-up' child

Correct answer: B

Rationale: The 'difficult' child is the best way to describe the child in this scenario. This temperament is characterized by high activity levels, irritability, irregular habits, and difficulty adapting to changes. Choice A, the 'easy' child, is known for being generally positive and adaptable. Choice C, the 'slow-to-warm-up' child, typically needs time to adapt to new situations but is not necessarily highly active or irritable. Choice D, the 'fast-to-warm-up' child, adapts quickly to new situations, which contrasts with the child's slow adaptation mentioned in the scenario.

5. The nurse is teaching the family of a child with a long-term central venous access device about signs and symptoms of bacteremia. What finding indicates the presence of bacteremia?

• A. Hypertension
• B. Pain at the entry site
• C. Fever and general malaise
• D. Redness and swelling at the entry site

Correct answer: C

Rationale: Fever and general malaise are systemic signs of bacteremia, indicating that the infection may have spread beyond the local entry site. Localized pain, redness, and swelling are signs of a localized infection but do not necessarily indicate bacteremia.

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