Nursing Elites

1. Where should the child admitted with injuries that may be related to abuse be placed?

• A. In a private room
• B. With an older, friendly child
• C. With a child of the same age
• D. In a room near the nurses’ desk

Correct answer: D

Rationale: The correct answer is to place the child in a room near the nurses’ desk. This placement allows for close monitoring and immediate intervention if needed, ensuring the safety and well-being of the child. Placing the child in a private room (Choice A) may limit visibility and monitoring. Putting the child with an older, friendly child (Choice B) or a child of the same age (Choice C) does not prioritize the necessary close monitoring and intervention that a child potentially experiencing abuse requires. Hence, placing the child in a room near the nurses’ desk is the most appropriate choice in this scenario.

2. Based on developmental norms for a 5-year-old child, a healthcare professional decides to withhold a scheduled dose of digoxin (Lanoxin) elixir and notify the healthcare provider. Below what apical pulse did the healthcare professional withhold the medication?

• A. 60 beats/min
• B. 70 beats/min
• C. 90 beats/min
• D. 100 beats/min

Correct answer: C

Rationale: For a 5-year-old child, an apical pulse below 90 beats/min is an indicator to withhold digoxin. Digoxin is a medication that affects the heart, and in pediatric patients, monitoring the pulse rate is crucial due to the risk of bradycardia (slow heart rate) as a potential side effect. In this case, an apical pulse of 90 beats/min or lower indicates a heart rate that may be too slow for a child of this age, warranting the withholding of digoxin and prompt notification of the healthcare provider. Choices A, B, and D are not within the critical range specified for withholding digoxin in a 5-year-old child and would not necessitate withholding the medication.

3. A parent tearfully tells a nurse, 'They think our child is developmentally delayed. We are thinking about investigating a preschool program for cognitively impaired children.' What is the nurse’s most appropriate response?

• A. Praise the parent for the decision and encourage the plan.
• B. Ask for more specific information related to the developmental delays.
• C. Advise the parent to have the healthcare provider help choose an appropriate program.
• D. Explain that this may be a premature action and the developmental delays could disappear.

Correct answer: B

Rationale: The most appropriate response for the nurse in this situation is to ask for more specific information related to the developmental delays. By seeking additional details, the nurse can better understand the situation, offer appropriate support, and provide guidance tailored to the child's specific needs. Praising the parent or encouraging the plan without understanding the full context may not be beneficial. Advising the parent to have the healthcare provider help choose a program assumes the parent has not already involved the healthcare provider, which may not be the case. Explaining that the developmental delays could disappear is not appropriate as it may give false hope or minimize the parent's concerns.

4. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

• A. absence of a urethral opening
• B. penis appears shorter than usual for age
• C. the urethral opening is along the dorsal surface of the penis
• D. the urethral opening is along the ventral surface of the penis

Correct answer: D

Rationale: Hypospadias is a congenital condition where the urethral opening is located along the ventral surface of the penis, not the dorsal surface (Choice C) or absent (Choice A). This leads to the characteristic appearance of a ventrally displaced urethral meatus. The penis may appear normal in size but with the urethral opening positioned abnormally (Choice D), rather than being shorter than usual (Choice B). Therefore, the correct expectation for a newborn with hypospadias is that the urethral opening is along the ventral surface of the penis, making Choice D the correct answer.

5. Seizures in children most often result from

• A. an abrupt rise in body temperature
• B. an inflammatory process in the brain
• C. a temperature greater than 102°F
• D. a life-threatening infection

Correct answer: A

Rationale: Seizures in children most often result from an abrupt rise in body temperature, leading to febrile seizures. Febrile seizures are common in young children and are typically triggered by a rapid increase in body temperature, often due to infections or other causes. An inflammatory process in the brain (Choice B) is less common as a cause of seizures in children and is usually associated with specific conditions like encephalitis or meningitis. While a temperature greater than 102°F (Choice C) may trigger a febrile seizure, it is the abrupt rise in temperature that is the primary cause. Choice D, a life-threatening infection, is a broad and less specific cause compared to the direct trigger of an abrupt rise in body temperature.

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