Nursing Elites

1. What test is used to screen for carbohydrate malabsorption?

• A. Stool pH
• B. Urine ketones
• C. C urea breath test
• D. ELISA stool assay

Correct answer: A

Rationale: Stool pH testing is used to screen for carbohydrate malabsorption. A low pH indicates the presence of unabsorbed carbohydrates, which are fermented by bacteria, leading to acidic stool.

2. What is the recommended position for a child with epiglottitis to ease breathing?

• A. Supine
• B. Prone
• C. Tripod
• D. Semi-Fowler’s

Correct answer: C

Rationale: The correct answer is C, 'Tripod.' In children with epiglottitis, the tripod position is recommended to help open the airway and ease breathing. This position involves the child sitting upright, leaning forward, and supporting themselves with their hands on their knees or another surface. This posture helps improve air entry into the lungs by maximizing the space for breathing. Choices A (Supine), B (Prone), and D (Semi-Fowler’s) are incorrect. Placing a child with epiglottitis in the supine position may further obstruct the airway, while the prone position and semi-Fowler’s position do not facilitate optimal air exchange in these cases.

3. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?

• A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
• B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
• C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
• D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.

Correct answer: D

Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.

4. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

• A. Recommend that the child keep a diary.
• B. Provide supplies for the child to draw a picture
• C. Suggest that the parent read fairy tales to the child
• D. Ask the parent if the child is always uncommunicative

Correct answer: B

Rationale: Drawing allows the child to express feelings and thoughts non-verbally, which can be particularly effective for children who have difficulty articulating their emotions.

5. Following treatment for iron deficiency anemia, the physician orders lab tests. Which lab value would indicate an improvement in the child’s condition?

• A. Low hemoglobin
• B. Normal platelet count
• C. High reticulocyte count
• D. Low hematocrit

Correct answer: C

Rationale: A high reticulocyte count indicates that the bone marrow is producing more red blood cells, which is a sign of recovery from anemia as the body replenishes its iron stores and increases hemoglobin levels. Low hemoglobin (Choice A) would indicate ongoing anemia rather than improvement. A normal platelet count (Choice B) and low hematocrit (Choice D) are not specific indicators of improvement in iron deficiency anemia.

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