Nursing Elites

1. Which of the following statements regarding pediatric anatomy is correct?

• A. The child's trachea is more rigid and less prone to collapse.
• B. The occiput is proportionately larger when compared to an adult.
• C. Airway obstruction is common in children due to their large uvula.
• D. Relative to the overall size of the airway, a child's epiglottis is smaller.

Correct answer: B

Rationale: The occiput, the back part of the head, is proportionately larger in children compared to adults, which can have implications for airway management techniques. This anatomical difference is important to consider when providing care to pediatric patients, especially during airway interventions.

2. When treating Baby John, who has been diagnosed with a lower respiratory infection, the selection of drugs of choice for the treatment depends primarily on:

• A. Preference of the physician
• B. Selectivity of the organism
• C. Sensitivity of the organism
• D. Tolerance of the client

Correct answer: C

Rationale: The primary factor in selecting drugs for the treatment of a lower respiratory infection in Baby John is the sensitivity of the organism causing the infection. The choice of antibiotics should be guided by the susceptibility of the specific pathogen to ensure effective treatment and prevent resistance.

3. How can the nurse best assess that the parents demonstrate understanding of the dressing change procedure prior to discharge for their child with burns?

• A. The parents explaining the importance of using sterile technique to the nurse.
• B. The nurse observing the parents changing the dressing using appropriate technique.
• C. The parents observing the nurse changing the dressing and confirming their understanding of the procedure.
• D. The nurse allowing the parents to explain the dressing change procedure and perform it in private to boost their confidence.

Correct answer: B

Rationale: The most effective way for the nurse to assess the parents' understanding of the dressing change procedure is by observing them as they change the dressing using the correct technique. This direct observation ensures that the parents are able to perform the task correctly and confidently before discharge. Merely verbalizing or explaining the procedure may not accurately reflect the parents' competency in performing the actual task. Choice A involves the parents explaining to the nurse, which does not directly assess their practical skills. Choice C suggests the parents observing the nurse, which does not evaluate the parents' ability to perform the task independently. Choice D focuses on boosting the parents' confidence but does not directly assess their understanding and competency in performing the dressing change.

4. Which behavior is most indicative that a 2-year-old is experiencing the initial phase of separation anxiety because his parents cannot stay all day at the hospital with him?

• A. He withdraws from the nursing staff.
• B. He cries when his parents leave.
• C. He lies quietly in bed.
• D. He cries when his parents arrive.

Correct answer: B

Rationale: The most indicative behavior of a 2-year-old experiencing the initial phase of separation anxiety due to parents not staying all day at the hospital is crying when his parents leave. This behavior is a common manifestation of separation anxiety in children, as they struggle with the absence of their primary attachment figures. Choices A, C, and D are less indicative because withdrawing from the nursing staff, lying quietly in bed, or crying when parents arrive do not specifically demonstrate the distress caused by separation from parents, which is the hallmark of separation anxiety in children.

5. What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?

• A. Insert the needle and aspirate before injecting
• B. Inject insulin into the extremity to be exercised to improve absorption
• C. The muscles in the abdomen and thigh are the easiest for self-administration
• D. Clean the injection site with soap and water and avoid alcohol

Correct answer: C

Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.

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