Nursing Elites

1. Which condition is characterized by a "barking" cough in children?

• A. Asthma
• B. Bronchiolitis
• C. Croup
• D. Pneumonia

Correct answer: C

Rationale: Croup is the correct answer. It is characterized by a distinctive "barking" cough, typically worse at night, caused by the inflammation of the upper airway, specifically the larynx and trachea. Asthma (Choice A) typically presents with wheezing and shortness of breath rather than a barking cough. Bronchiolitis (Choice B) commonly causes wheezing and respiratory distress in infants and young children. Pneumonia (Choice D) often presents with symptoms like fever, productive cough, and chest pain, but not typically a barking cough.

2. The LPN is caring for a 1-month-old patient post-surgery. Which pain scale is expected to be used to evaluate post-op pain?

• A. Oucher
• B. Wong-Baker FACES
• C. FLACC
• D. 0-10 pain scale

Correct answer: C

Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is commonly used to assess pain in infants and young children who are unable to verbally communicate their pain. This scale is particularly useful in assessing post-operative pain in infants as it evaluates different behaviors and physiological responses to pain. The Oucher scale is more commonly used with children who are older and can provide self-report of pain intensity. Wong-Baker FACES scale is primarily used with children who are older and can indicate their pain level by pointing to facial expressions. The 0-10 pain scale is typically used with older children and adults who can rate their pain on a numerical scale.

3. A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and doses of immunizations. What is the most appropriate nursing intervention?

• A. Administer initial immunizations from the beginning of the schedule.
• B. The child cannot receive missed immunizations if the schedule is not followed and will not be vaccinated.
• C. The child should only receive the missed doses of immunizations based on the catch-up schedule.
• D. The child should receive double-strength immunizations at this well visit.

Correct answer: C

Rationale: Children who began primary immunization at the recommended age but fail to receive all the doses do not need to begin the series again but should receive only the missed doses. The child may receive missed vaccinations on a catch-up schedule per CDC guidelines.

4. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?

• A. Send the child to his or her room if the child has one.
• B. A general rule for length of time is 1 hour per year of age.
• C. Select an area that is safe and nonstimulating, such as a hallway.
• D. If the child cries, refuses, or is more disruptive, try another approach.

Correct answer: C

Rationale: Time-outs should be in a safe, nonstimulating area, with the length typically being 1 minute per year of the child's age, not 1 hour.

5. An infant is suspected of having esophageal atresia/tracheoesophageal fistula. While waiting for the pediatrician to see the infant, which action should the nurse take?

• A. Position the infant with the head of the bed slightly elevated
• B. Allow the infant to bond with the mother in her room
• C. Offer the infant breastfeeding instead of formula feeding
• D. Wrap the infant in blankets and place in a crib by the viewing window

Correct answer: A

Rationale: Positioning the infant with the head of the bed elevated helps to prevent aspiration and manage secretions until further treatment can be provided. Choice B is incorrect as the priority is ensuring the infant's safety and health, not immediate bonding. Choice C is incorrect as breastfeeding may worsen the condition. Choice D is incorrect as it does not address the potential risk of aspiration associated with esophageal atresia/tracheoesophageal fistula.

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