Nursing Elites

1. What type of play do nurses expect when observing a toddler in a playroom with other children?

• A. Parallel
• B. Solitary
• C. Cooperative
• D. Competitive

Correct answer: A

Rationale: The correct answer is A: Parallel. Toddlers typically engage in parallel play, where they play alongside but not directly with other children. This type of play is common during early childhood as children are still developing social skills and may prefer to play independently while observing others. Choice B, Solitary play, refers to a child playing alone without interacting with others. Choice C, Cooperative play, involves children playing together towards a common goal or activity. Choice D, Competitive play, emphasizes winning and outperforming others, which is less common in toddlers as they are in the stage of exploring and learning through play rather than competing.

2. The nurse is implementing care for a school-age child admitted to the pediatric intensive care unit with diabetic ketoacidosis (DKA). Which prescribed intervention should the nurse implement first?

• A. Begin 0.9% saline solution intravenously as prescribed
• B. Administer regular insulin intravenously as prescribed
• C. Place the child on a cardiac monitor
• D. Place the child on a pulse oximetry monitor

Correct answer: A

Rationale: The correct first intervention when managing a child with diabetic ketoacidosis is to begin intravenous saline solution to address dehydration and restore electrolyte balance. Rehydration is essential to improve perfusion and correct electrolyte imbalances. Administering insulin without addressing dehydration can potentially lead to further complications. Placing the child on a cardiac monitor or pulse oximetry monitor is important but not the initial priority in managing DKA.

3. A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?

• A. Administering a bronchodilator
• B. Administering an antihistamine
• C. Administering a corticosteroid
• D. Administering oxygen

Correct answer: A

Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways quickly, providing immediate relief by opening up the narrowed air passages in asthma. Antihistamines are not the first-line treatment for asthma exacerbations and may not address the underlying bronchoconstriction. Corticosteroids are important for long-term control of asthma but may take longer to have an effect compared to bronchodilators. Administering oxygen is essential for hypoxemia in asthma exacerbations, but the priority is to relieve bronchoconstriction promptly with a bronchodilator.

4. The mother of a 5-year-old boy with a myelomeningocele, who has developed a sensitivity to latex, is being taught by the nurse. Which response from his mother indicates a need for further teaching?

• A. He needs to wear a medical alert identification.
• B. I will need to inform his caregivers about his latex sensitivity.
• C. A product's label always indicates whether it is latex-free.
• D. He must avoid any contact with latex.

Correct answer: C

Rationale: Choice C, 'A product's label always indicates whether it is latex-free,' indicates a need for further teaching. Not all products are clearly labeled as latex-free; therefore, it is essential to verify with manufacturers and healthcare providers. Choices A, B, and D demonstrate appropriate understanding of managing latex sensitivity in the child. Wearing a medical alert identification (Choice A), informing caregivers (Choice B), and avoiding all contact with latex (Choice D) are all important aspects of managing a child's latex sensitivity.

5. A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration.

• A. Lispro
• B. Regular
• C. NPH
• D. Glargine

Correct answer: D

Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (Humalog) and Regular (short-acting) insulins have shorter durations of action, typically lasting 3 to 6 hours. NPH (Neutral Protamine Hagedorn) insulin has an intermediate duration of action, lasting around 12 to 18 hours. Therefore, choices A, B, and C are incorrect in the context of insulin duration.

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