Nursing Elites

1. Which immunization should the nurse include in a teaching session for parents of toddler-age clients to decrease the risk for epiglottitis?

• A. Hepatitis B
• B. Polio
• C. Measles, mumps, and rubella (MMR)
• D. Hemophilus influenzae type B (Hib)

Correct answer: D

Rationale: The correct answer is D, Hemophilus influenzae type B (Hib) vaccine. Hib vaccine is crucial in preventing epiglottitis, a serious respiratory condition caused by Haemophilus influenzae type b bacteria. This vaccine is recommended for toddlers to protect them from developing epiglottitis. Choices A, B, and C are incorrect because while they are important vaccines for children, they do not specifically target the prevention of epiglottitis, unlike the Hib vaccine.

2. A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

• A. Stimulate appetite
• B. Detect evidence of edema
• C. Minimize risk of infection
• D. Promote adherence to the antibiotic regimen

Correct answer: C

Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.

3. What is the most common cause of acute gastroenteritis in children under 5 years?

• A. Salmonella
• B. Rotavirus
• C. Norovirus
• D. Shigella

Correct answer: B

Rationale: Rotavirus is the leading cause of acute gastroenteritis in children under 5 years. It leads to severe diarrhea and dehydration. Vaccination against rotavirus has significantly reduced the incidence of this disease, but it remains a major cause of morbidity in young children globally. Salmonella and Shigella can cause gastroenteritis, but they are less common in children under 5 years. Norovirus is also a common cause of gastroenteritis, but Rotavirus is the most prevalent in this age group.

4. After teaching a group of nursing students about developmental milestones for children between the ages of 1 and 4 years, the instructor determines that the teaching was successful when the students identify which of the following as a gross motor developmental milestone that occurs between 2 to 3 years of age?

• A. Jumping in place
• B. Climbing
• C. Standing on one foot with help
• D. Riding a tricycle

Correct answer: B

Rationale: Climbing is a gross motor milestone typically achieved between 2 to 3 years of age. It involves coordination and strength. Jumping in place is usually mastered around 2 years of age. Standing on one foot with help is a skill that emerges around 3 years. Riding a tricycle typically occurs closer to 3 years and involves coordination and balance, which are more refined skills compared to climbing at an earlier age.

5. The mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils and adenoids complains that he has begun sucking his thumb again. Which defense mechanism should the nurse include when responding to the mother?

• A. Repression
• B. Regression
• C. Rationalization
• D. Fantasy

Correct answer: B

Rationale: The correct answer is B: Regression. Regression is a common defense mechanism where a child reverts to an earlier stage of development, such as thumb-sucking, to cope with stress. In this scenario, the 6-year-old boy is using thumb-sucking (a behavior typical of earlier developmental stages) as a way to deal with the stress of surgery. Repression (choice A) involves unconsciously blocking out thoughts or feelings, which is not applicable in this case. Rationalization (choice C) is a defense mechanism where illogical or unreasonable explanations are provided to justify behavior, which is not relevant here. Fantasy (choice D) refers to the use of imagination to escape from reality, which is also not the appropriate defense mechanism for the situation described.

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