Nursing Elites

1. When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'

• A. keep medications in a medicine cabinet.
• B. have secured gates at entrances to staircases.
• C. move our child to a regular bed by the age of three.
• D. buy shoes that fasten with Velcro rather than laces.

Correct answer: C

Rationale: The correct answer is C. Moving a child to a regular bed by the age of three can increase the risk of falls as young toddlers may not have the motor skills to safely navigate a larger bed. This indicates a need for more teaching on safety measures. Choices A, B, and D are all appropriate safety measures that can help prevent accidents and injuries in young children. Keeping medications in a medicine cabinet, having secured gates at entrances to staircases, and choosing shoes that fasten with Velcro instead of laces are all good practices to ensure a safe environment for toddlers.

2. Which observation made of the exposed abdomen is most indicative of pyloric stenosis?

• A. abdominal rigidity
• B. substernal retraction
• C. palpable olive-like mass
• D. marked distention of lower abdomen

Correct answer: C

Rationale: The correct answer is C: palpable olive-like mass. In pyloric stenosis, a palpable olive-like mass can often be felt in the abdomen due to the hypertrophied pyloric muscle. This mass is a key characteristic finding in infants with pyloric stenosis. Choice A, abdominal rigidity, is more commonly associated with conditions like peritonitis. Choice B, substernal retraction, is not typically seen in pyloric stenosis but can be a sign of respiratory distress. Choice D, marked distention of the lower abdomen, is not specific to pyloric stenosis and can be present in various abdominal conditions.

3. The parents of a 2-year-old child tell the nurse that they are having difficulty disciplining their child. What is the nurse’s most appropriate response?

• A. “This is a difficult age that your child is going through right now.”
• B. “Tell me more about your difficulty. I’m not sure what you mean by this.”
• C. “It’s important to be consistent with toddlers when they need disciplining.”
• D. “I can understand what you mean. That’s why this age is called the terrible twos.”

Correct answer: C

Rationale: The most appropriate response for the nurse is to emphasize the importance of consistency in discipline when dealing with toddlers. Toddlers are at an age where they are learning boundaries and acceptable behaviors. By being consistent, parents can help their child understand what is expected of them and establish a sense of structure and routine. Choices A, B, and D do not provide constructive advice or guidance on how to address the issue of disciplining a 2-year-old. Choice A merely acknowledges the age without providing guidance, choice B seeks more information without offering support, and choice D labels the age without offering practical advice on discipline.

4. A nurse is reviewing the immunization schedule of an 11-month-old infant. What immunizations does the nurse expect the infant to have previously received?

• A. Pertussis, tetanus, polio, and measles
• B. Diphtheria, pertussis, tetanus, and polio
• C. Rubella, polio, tuberculosis, and pertussis
• D. Measles, mumps, rubella, and tuberculosis

Correct answer: B

Rationale: By 11 months of age, the recommended vaccines for infants include diphtheria, pertussis, tetanus, and polio. These vaccines are part of the routine immunization schedule to protect infants from serious infectious diseases. Choice A is incorrect because measles is not typically administered at this age. Choice C is incorrect because rubella and tuberculosis are not part of routine infant immunizations. Choice D is incorrect because measles, mumps, and rubella are usually given as a combination vaccine later in childhood, not at 11 months of age.

5. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?

• A. Monitor for signs of infection
• B. Monitor blood pressure
• C. Monitor for hyperglycemia
• D. Monitor for hypertension

Correct answer: A

Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention, reducing the risk of complications. While monitoring blood pressure (choice B) is important in nephrotic syndrome, it is not the most immediate concern when the child is on corticosteroids. Monitoring for hyperglycemia (choice C) is relevant in corticosteroid therapy, but the priority in this scenario is to watch for signs of infection. Monitoring for hypertension (choice D) is important in nephrotic syndrome but is not the most critical consideration when the child is on corticosteroids.

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